If you are a Primary Care Practitioner or work in a physician's office, the following information will make it easier for you to work with us.
Primary Care Practitioner Priority Phone Line
Call 613-310-2222 and press '2' to speak with an Information & Referral Specialist - every
Making a Referral
If you have a patient with an acute or chronic care need that is not met with current treatment and supports, we can provide a variety of services to facilitate care in the home and the community. We also assess and determine eligibility for long-term care and respite care.
To make a referral to us, download our referral form. For Long-Term care referrals, complete both the referral form AND a Ministry of Health and Long-Term Care Health Assessment Form 4768-69E (2015/01). These Health Assessment forms were introduced by the MOH-LTC in the spring of 2015 and are also available on their website directly.
View our Physician Fact Sheet for billing codes and additional details about our services.
making a referral for palliative care
Champlain Hospice Palliative Symptom Management Kit
A Champlain Hospice Palliative Symptom Management Kit (SMK) is available for palliative care clients who require access to medications and supplies needed in urgent palliative care situations in the home. The SMK includes enough medications and related medical supplies to manage the palliative client's distressing symptoms in the home for a 24 to 72 hour period.
For Physicians requesting the SMK, please download the Medication Order Form
- The Medication Order Form
For more information about the Champlain Palliative Symptom Management Kit (SMK), please call (613) 310-2222.
Symptom Management Referrals for Infusion Therapy
Physicians who order medications that are administered for pain and symptom management by infusion route are encouraged to complete the Medical Referral Infusions for Symptom Management that provides an efficient, comprehensive method of ordering and obtaining this specialized care for patients. View our Physician Fact Sheet for additional details and instructions.
- The Regional Palliative Consultation Team
The Regional Palliative Consultation Team connects, supports and cares for patients who have a life-limiting illness in the Champlain region. Our nurses help people and families understand their options and provide support. Learn more.
Referrals for home-based palliative care can be made through us.
Download an RPCT Referral Form and view a brochure.
MEDICAL ASSISTANCE IN DYING (MAiD)
Information for Physicians and Nurse Practitioners
The following information outlines our role in Medical Assistance in Dying, available services, requirements, and timelines, in order to be able to arrange services for patients who are requesting Medical Assistance in Dying at home.
Champlainhealthline.ca features current and reliable information about more than 3000 health and community services in the region. Search for services by keyword, postal code, category or alphabetical.
Consult the list of Primary Care Desktop Resource Guides to quickly access phone numbers and websites related to a number of health and community services.
Health Care Connect
We are a key partner in Health Care Connect, a program that connects patients with primary care providers. Our Care Connectors can link you to unattached patients. Learn more »
Working hand-in-hand with Primary Care
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