South East

Information and Referral

310-2222

(No area code required)

Toll-free:1-800-668-0901
Fax:1-866-839-7299
TTY:711
Email:SEComments@hccontario.ca

IMPORTANT: DO NOT send any personal health information. This email is not for patient feedback or referrals. Please call us directly at the numbers listed above. We aim to respond within 72 hours, however, this email account is not checked on weekends or statutory holidays.

Visit South East Healthline

South East Healthline logo in English

South East Office Locations

  • Belleville (Corporate Office)
    470 Dundas St. East
    Belleville, ON, K8N 1G1
    Toll-free:  1-800-668-0901
    Fax:  613-966-0996
  • Bancroft
    1 Manor Lane
    Bancroft, ON, K0L 1C0
    Toll-free:  1-800-717-2344
    Fax:  613-966-0996
  • Brockville
    555 California Ave., Unit 1, Bag Service 7000
    Brockville, ON, K6V 7K6
    Toll-free:  1-800-267-6041
    Fax:  613-283-0308
  • Kingston
    200-1471 John Counter Blvd.
    Kingston, ON, K7M 8S8
    Toll-free:  1-800-869-8828
    Fax:  613-544-1494
  • Smiths Falls
    52 Abbott St. N., Suite 1
    Smiths Falls, ON, K7A 1W3
    Toll-Free:  1-800-267-6041
    Fax:  613-283-0308

Compliments and Concerns?

Please share your feedback with your care coordinator. You may also share compliments or concerns in the following ways:

Email: SEQuality@hccontario.ca

Phone: 613-650-2987

Mail: Home and Community Care Support Services South East Compliments and Concerns
Attn: Senior Manager, Quality
470 Dundas St. East
Bay View Mall
Belleville, ON K8N 1G1

Newsroom and Media Relations

Visit our newsroom for more information on news and events. 

For all media-related enquiries, please contact HCCSSmedia@hccontario.ca.

For non-media-related enquiries about Home and Community Care Support Services and to serve you best, please visit the Contact Us page to access additional contact information.

Forms

TitleSummaryRegionLast ModifiedCategoryFile TypeFile SizeLinkhf:doc_tagshf:doc_categorieshf:file_type
CADD SOLIS – PCA Prescription Order

Continuous Ambulatory Delivery Device Patient Controlled Analgesia Prescription Order – South East

October 10, 2023pdf6 MBsouth-eastformspdf
COVID-19 Remote Monitoring Program Referral Form

Patients enrolled in the COVID-19 Remote Monitoring Program use an app on their smartphone to report their symptoms to their nurse.

January 31, 2024pdf87 KBsouth-eastformspdf
First Dose Parenteral Medication Screener

First Dose Parenteral Medication Screener – South East

September 14, 2022pdf452 KBsouth-eastformspdf
Infusion Therapy – IV Remdesivir Referral Form

Referral form for administering COVID-19 antivirals in South East community nursing clinics.

August 30, 2023pdf237 KBsouth-eastformspdf
IV therapy/venous access management medical orders

South East IV therapy/venous access management medical orders

September 14, 2022pdf340 KBsouth-eastformspdf
Long-Term Care Home Choice Form (English)

You may choose up to five (5) long-term care homes.

June 8, 2023pdf1 MBsouth-eastformspdf
Long-Term Care Home Choice Form (French)

Formulaire de choix de foyer de soins de longue durée. Vous pouvez choisir jusqu’à cinq (5) foyers de soins de longue durée.

June 8, 2023pdf386 KBsouth-eastformspdf
MAID Assessment Record

South East Medical Assistance in Dying Assessment Record

September 14, 2022pdf279 KBsouth-eastformspdf
MAID Prescription/Order Form

South East Medical Assistance in Dying Prescription/Order Form

September 14, 2022pdf278 KBsouth-eastformspdf
MAID Procedural Record

South East Medical Assistance in Dying Procedural Record

September 14, 2022pdf256 KBsouth-eastformspdf
Medical Order Form

Home and Community Care Support Services South East Medical Order Form

August 14, 2023pdf458 KBsouth-eastformspdf
MHAN Referral Form

South East Mental Health and Addiction Nursing referral form

May 19, 2023pdf222 KBsouth-eastformspdf
Negative Pressure Wound Therapy Order

South East Negative Pressure Wound Therapy Order form cannot be initiated without negative pressure setting, therapy setting and contingency dressing orders.

February 9, 2023pdf1 MBsouth-eastformspdf
Palliative Care SBAR Communication Tool for Nurses

Palliative Care SBAR Communication Tool for Nurses in the South East

September 14, 2022pdf263 KBsouth-eastformspdf
Referral and Order Requisition for Offloading Devices

Complete this form to refer patients to approved regional providers for offloading footwear

September 12, 2023pdf1 MBsouth-eastformspdf
Referrals from Hospital

Home and Community Care Support Services South East referrals from hospital

August 14, 2023pdf328 KBsouth-eastformspdf
Service Requests/Referrals

Home and Community Care Support Services South East service request/referral form

August 14, 2023pdf591 KBsouth-eastformspdf
SRK for End-of-Life Order Form

Timing and placement of the Symptom Response Kit requires careful consideration with a goal of avoiding emergency room visit or hospital admission.

June 6, 2023pdf1 MBsouth-eastformspdf