Professionnels de la santé

Nous vous demandons de faire preuve de patience envers nous tandis que nous travaillons à la traduction vers le français du site Web de notre hôpital. Vous pouvez obtenir des renseignements liés à ce sujet dans la version anglaise de notre site en cliquant ici. S'il vous faut obtenir ces renseignements en français, communiquez avec bardone@hdh.kari.net.

Adult Eating Disorders Program

South Eastern Ontario Addictions & Mental Health Service Access Form

Adult-Mental Health Services Referral Form

South Eastern Ontario Addictions & Mental Health Service Access Form

Audiology Physician Referral Form

Breast Assessment Program Imaging Requisition

Cardiac Diagnostic Test Requisition

Cardiac Rehabilitation Centre Referral

For more information visit Cardiac Rehabilitation Centre

Child & Adolescent Eating Disorder Program Referral

Chronic Obstructive Pulmonary Disease (COPD) Referral Form

Chronic Pain Clinic Referral Form (Anesthesiology)

Legend:

  • CT -  Computerized Tomography
  • EMG - Electromyography
  • MRI - Magnetic Resonance Imaging
  • DND - Department of National Defence (Canada)
  • ODSB - Ontario Disability Support Program
  • WSIB - Workplace Safety and Insurance Board

Colorectal Cancer Screening Referral Form

Colorectal Diagnostic Assessment Program - Referral Form

South East Regional Cancer Program in parnership with Cancer Care Ontario

Consultation for Interventional Radiology

Used only at KGH.

CT Requisition

Used at both HDH and KGH.

Dermatology Clinic

Referral Guidelines for General Dermatology.

Diabetes Education & Management Centre Referral Form

Fecal Fat Test Instructions

Flexible Sigmoidoscopy Referral Form (Registered Nurse Performed)

GI Function Testing Unit Breath Test & Fecal Fat Requisition

Heads Up! Early Psychosis Intervention Program

Heart Failure Clinic, Brock 1 Referral Form

Hip and Knee Referral Form

Imaging Services Requisition

Used at both HDH and KGH; applies to General Radiology, Ultrasound & Nuclear Medicine studies (NOT to be used for breast imaging).

Lung Diagnostic Assessment Program (Lung DAP) - Referral Form

South East Regional Cancer Program in partnership with Cancer Care Ontario

Mohs Clinic Referral Form

Ophthalmology Referral Form

Emergency eye clinic and General Ophthalmology. Urgent consults (<24h) must be discussed directly with on-call resident available through HDH or KGH switchboard.

Pulmonary Function Laboratory Referral & Test Request

Telemedicine Clinical Referral