Follow the steps to complete the form correctly.

1. Press the ‘Get Form’ button to obtain the form and access it in the online editor.
2. Begin by entering your name in the designated field at the top of the form. Ensure to use your legal name as it appears on official documents.
3. Fill in your complete address, including street address, city, and postal code, ensuring accuracy for communication purposes.
4. Indicate your sex by selecting 'M' for male, 'F' for female, or 'undifferentiated' or 'unknown' based on your identification preferences.
5. Provide your date of birth in the specified format, typically as day, month, and year, to ensure correct records.
6. Enter your Health Card Number (HCN) in the appropriate field for identification in the healthcare system.
7. Complete the section for your primary care provider by entering their name and phone number to facilitate easy communication.
8. If applicable, state the hospital site if you are currently admitted, as this may be relevant for your assessment.
9. In the primary diagnosis section, select 'Yes' or 'No' to indicate if you have a diabetic condition.
10. If you have been diagnosed with cancer or a life-limiting illness, provide details such as whether there is metastatic spread and the type of ongoing treatment you are receiving.
11. Detail any allergies you may have in the pertinent section, ensuring they are noted for your safety during treatment.
12. In the reason for referral section, specify that the form is for a case management assessment request or outline any other relevant information.
13. Complete the medical orders section, ensuring that all orders are signed by the appropriate physician or nurse practitioner and include their details.
14. Review your entries for accuracy and completeness, then save changes, and select options to download, print, or share the form as required.

Complete your Canada CE-CM-605 - Ontario form online today for a streamlined assessment process.