Get Ottawa-carleton Community Care Access Centre

Filling out the OTTAWA-CARLETON COMMUNITY CARE ACCESS CENTRE referral form can seem daunting, but with clear guidance, the process can be straightforward. This guide provides step-by-step instructions to help you accurately complete the form online, ensuring your application is processed efficiently.

Follow the steps to successfully complete your referral form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Start by selecting your preferred language for service from the options provided: French, English, or Other.
3. Fill in your personal details, including your name, address, date of birth, and phone number. Ensure all information is legible.
4. Indicate the Health Services Number (HSN) and provide the referral source's information, including their contact number and BRN #.
5. List any allergies or infective organisms and note specific precautions needed, such as droplet, airborne, contact, or routine.
6. Specify the type of referral: community, hospital inpatient, outpatient, or day surgery, and provide the relevant discharge date if applicable.
7. Detail the diagnosis or medical history and any procedures that need to be taught to the patient or a reliable caregiver.
8. If applicable, fill in the wound care order and specify the type of wound treatment needed.
9. Outline any intravenous medications required, specifying first and next doses, stop dates, and contingencies for missed or delayed doses.
10. Indicate if follow-up blood work is arranged and if any additional sections are required.
11. Consult the service needs section and check off any additional therapies needed, such as physiotherapy, occupational therapy, or social work.
12. Once all sections are completed, ensure the physician signs and dates the form to validate medical orders.
13. After reviewing the completed form for accuracy, save any changes, and download, print, or share the form as needed.

Start filling out your OTTAWA-CARLETON COMMUNITY CARE ACCESS CENTRE referral form online today!