Hotel Dieu Shaver Referral & Admission Guidelines for are provided here for health care professionals to download.
Inpatient Programs 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 care programs offered at Hotel Dieu Shaver Health and Rehabilitation Centre.
If further assistance is required in making this determination, please call 905-685-1381, ext. 84242.
Complex Care (CC) Referral / Inpatient Referral Form | Download
Program Streams & Admission Guidelines | Download
Behavioural Assesment Form CCAC |
Patient Flow's Complex Care Admission Application | Download
Patient Letter of Understanding | Download
Palliative Performance Scale | Download
Complex Care Clinical Update Tool | Download
Fax completed Inpatient Forms to: 905-685-0206
Outpatient Programs
If you require assistance in completing the form or require further information regarding outpatient referrals, please call 905-685-1381.
Outpatient Rehab Referral Form | Download
Fax completed Outpatient Referral form to: 905-688-9905.
Electrodiagnostic Referral Form | Download
Fax completed Electrodiagnostic Requisition form to: 905-685-7703
Cancer Rehab Form | Download
Physician's Office - 547 Glenridge Avenue
Referrals to physiatrists can be made via fax -
Dr. Rick McMillan & Dr. Cristina Batey phone ext. 85306 | fax 905-687-3244
Dr. Omar Khan & Dr. Paul Stacey phone ext. 85201 | fax 905-687-3238
If you require assistance in completing the form or require further information regarding Physicians referrals, please call 905-685-1381, ext. 85306.
Glenridge Orthopaedic & Sports Medicine Office
Dr. Prateek Goyal, Dr. Chris Robert, Dr. Nathan Sacevich - 905-685-1381 ext. 84364