South West

Information and Referral

310-2222

(No area code required)

Toll-free:1-800-811-5146
Fax:519-472-4045
TTY:1-800-811-5147
Email:SWAccessIandR@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 West Healthline

South West Healthline

South West Office Locations

  • London(Corporate Office)
    356 Oxford Street West,
    London, ON, N6H 1T3
    Fax:   519-472-4045
  • Owen Sound
    1415 1st Avenue West,
     Suite 3009,
    Owen Sound, ON, N4K 4K8
    Fax:  519-371-5612
  • St. Thomas
    1063 Talbot Street,
    Unit 70,
    St. Thomas, ON, N5P 1G4
    Fax:   519-631-2236
  • Stratford
    65 Lorne Avenue East
    Stratford, ON, N5A 6S4
    Fax:   519-273-2847
  • Woodstock
    1147 Dundas Street,
    Woodstock, ON, N4S 8W3
    Fax:  519-539-0065

Compliments and Concerns?

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

Email: sw.feedback@hccontario.ca 

Phone: 519-473-2222 (1-800-811-5146)

Mail:

Attn: Patient Relations Department
356 Oxford Street West, London, ON N6H 1T3

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
Adult Intravenous Remdesivir Infusion Therapy Order Form

Ministry of Health only provides coverage for a maximum of three doses for an eligible patient. Determining and providing proof of patient eligibility for IV Remdesivir therapy is the Prescriber’s responsibility, namely: The individual does not require hospitalization; AND the individual cannot take Paxlovid (nirmatrelvir and ritonavir), e.g., due to a drug interaction or contraindication;AND the individual has a positive COVID-19 test result (molecular or rapid antigen) and has had symptoms for fewerthan 8 days at the time treatment is initiated (dose 1).

February 7, 2024pdf90 KBsouth-westformspdf
MHAN Referral Form

Mental Health and Addictions Nursing Program Referral Form

June 1, 2023pdf81 KBsouth-westformspdf
Physician Notification of Concern or Compliment

September 27, 2022pdf95 KBsouth-westformspdf
South West Adult Parenteral Antibiotic Therapy Order Form

Orders are processed between 8 am– 8pm, 7days/week and require a minimum 4-hour turn around window.
HCCSS South West uses a Clinic First Approach to service delivery.

January 29, 2024pdf107 KBsouth-westformspdf
South West Adult Standard Flush Protocol

September 27, 2022pdf258 KBsouth-westformspdf
South West community nursing clinic fact sheet for prescribers

South West Community nursing clinic fact sheet for prescribers

October 18, 2022pdf95 KBsouth-westformspdf
South West Enteral Feeding Form – Adult

January 26, 2023pdf653 KBsouth-westformspdf
South West Hydration Form

September 27, 2022pdf156 KBsouth-westformspdf
South West IV First Dose and Iron Sucrose Screener

September 27, 2022pdf95 KBsouth-westformspdf
South West MAID Referral Form

South West MAID referral form

May 18, 2023pdf170 KBsouth-westformspdf
South West Negative Pressure Wound Therapy Referral Form

January 18, 2023pdf155 KBsouth-westformspdf
South West Pain Management Order Form

September 27, 2022pdf263 KBsouth-westformspdf
South West Referral Form

September 27, 2022pdf335 KBsouth-westformspdf
South West Symptom Response Kit Prescription Form

September 22, 2022pdf208 KBsouth-westformspdf
SW Diabetes Type 1 Request Treatment Order

Request for Type 1 Diabetes Treatment Order

October 26, 2023pdf59 KBsouth-westformspdf
SW Palliative Care – Community Services Assessment Request

Request for palliative services in the community

October 26, 2023pdf88 KBsouth-westformspdf
Wound Consult Request – Virtual

A referral form to request a virtual wound consult with an NSWOC/WCS/ET or Nurse Practitioner from the South West Regional Wound Care Program.

March 6, 2024pdf71 KBsouth-westformspdf