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Careers

Home / Partners / Health-care Providers / Physicians

Primary Care Practitioner

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 access this physicians-only line. An Information & Referral Specialist will take your call every day from 8 am to 8 pm.

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 Ministry in 2015, and are also available on their website directly.

View our Primary Care Resource Sheet for Home and Community Care Supports 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 palliative symptom management, please download our Palliative SMK – Medication Order Form.

For more information about the our palliative 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.

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 a referral form and view a brochure.

MEDICAL ASSISTANCE IN DYING

Information for Physicians and Nurse Practitioners

This information outlines our role in medical assistance in dying (MAiD), available services, requirements, and timelines, to be able to arrange services for patients who are requesting MAiD at home.

See also:

List of forms And Information

Aminoglycoside Screening Algorithm	Guide for when to order bloodwork in the community
Community IV Therapy Venous Access Algorithm	Guide to assist with the decision of peripheral, versus central venous access device catheters
Telehomecare Remote Monitoring Program Referral Form	For this telehomecare program Program info: Primary Care Provider Patient
COVID-19 Remote Monitoring Program - Referral Form	For this telehomecare program
First Dose Parenteral Medication Administration Guideline	From the Champlain Community Infusion Quality Council, a guide to determine if the first dose of a drug can be safely administered in the community
General Referral Form (see also "Medical Referral Form", below)	For primary care to request community services
IV Access Care - Referral Form	Used to order IV therapy
Medical Referral Form (see also "General Referral Form", above)	Usually used by hospital and outpatient clinics to request home care services
Medical Referral Infusions for Symptom Management	To order medications via CADD Solis pump
Ministry of Health and Long-Term Care Health Assessment Form 4768-69E (2015/01)	Required document for LTC applications
Negative Pressure Wound Therapy (NPWT) - Prescription Form	Used to order NPWT
Palliative Symptom Management Kit - Medication Order Form	Easy-to-use order guide and form for prescribing symptom management medications and supplies in the community
Primary Care - Resource Sheet	General information for primary care, including billing codes
Regional Palliative Care Team - Referral Form	For consultation in palliative pain and symptom management, and complex end-of-life care

Champlain healthline

Champlainhealthline.ca features current and reliable information about more than 3,000 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

We are always trying to improve the content of our website. If you have feedback please contact communications@lhins.on.ca.

uOttawa's Faculty of Medicine

To stay up-to-date on uOttawa's Faculty of Medicine news, achievements and events, please visit MedPoint.

Our name has changed but local services and contact information remain the same, including home and community care and long-term care home placement. Health system planning and funding functions are now part of Ontario Health.