• PATIENT REFErRAL FORMS
• In-patient ccc/rehab
• out-patient rehab
• physiatry consultations

• Introduction
• Philosophy of Care
• Outpatient Rehabilitation Team
• Orthopedic
• Neurology
• Audiology
• Clinical Communications
• Recreation Therapy Services
• Network Niagara
• Information for Referring Professionals
• Patient Referral Form

Admission Guidelines:

These guidelines have been developed to assist health care professionals in determining if a patient is eligible for admission to the inpatient rehabilitation and complex continuing care programs offered at the Hotel Dieu Shaver Health and Rehabilitation Centre.  If further assistance is required in making this determination, please call 905-685-1381 ext. 4204.

In-Patient Referral Forms (CCC & Rehab):

For your convenience, we have made available for download the in-patient referral form for Complex Continuing Care and Rehab. This form must be printed, completed and faxed to our Admitting Department at
905-685-0206.

If you require assistance in completing the referral form or require further information regarding admission to Hotel Dieu Shaver Health and Rehabilitation Centre, please call 905-685-1381 ext. 4242.

Outpatient Referrals

For your convenience, we have made available for download the outpatient referral form.  This form must be printed, completed and faxed to our Health Records department at 905-688-9905.

If you require assistance in completing the form or require further information regarding outpatient referrals to Hotel Dieu Shaver Health and Rehabilitation Centre, please call 905-685-1381 ext. 5230.

Dorothy Ort Clinic

This form is available for the purposes of inpatient and outpatient physiatry consultations and rehab review for patients in Niagara.