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Comfort. Care. Hope.

Admissions Guidelines

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:  905-687-3226

Cancer Rehab Form | Download


Physician's Office - 547 Glenridge Avenue

Referrals to physiatrists can be made via fax -

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


Renewing Hope. Rebuilding Lives.

Hotel Dieu Shaver Health and Rehabilitation Centre is a specialty hospital that excels in providing rehabilitation and complex care to thousands of patients across the Niagara Region.

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