Erie St. Clair area
We are now Ontario Health atHome (opens in a new tab) , a single organization coordinating local home and community care, long-term care placement and help finding services in the community. Our name has changed but our services remain the same. Patients continue to work with the same patient care teams and can contact us the same way.
Information and Referral
310-2222
Toll-free:1-888-447-4468
TTY:711 (caller to ask for 1-888-447-4468)
esc.engagement@ontariohealthathome.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.
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 Erie St. Clair Healthline
Erie St. Clair Area Office Locations
-
Chatham (Corporate Office)
180 Riverview Drive
Chatham, ON, N7M 5Z8
Fax: Chatham-Kent – 519-351-5842 -
Sarnia Office
1150 Pontiac Drive,
Sarnia, ON, N7S 3A7
Fax: Sarnia-Lambton – 519-337-4331 -
Windsor Office
5415 Tecumseh Road, East,
Windsor, ON, N8T 1C5
Fax: Windsor-Essex – 519-258-6288
Compliments and Concerns?
Please share your feedback with your care coordinator. You may also share compliments or concerns in the following ways:
Email: Esc.PatientRelations@ontariohealthathome.ca
Phone: 1-888-447-4468 ext. 7777
Mail: Ontario Health atHome
Attn: Patient Relations Specialist
180 Riverview Drive
Chatham, ON N7M 5Z8
Newsroom and Media Relations
Visit our newsroom for more information on news and events.
For all media-related enquiries, please contact media@ontariohealthathome.ca.
For non-media-related enquiries, please visit the Contact Us page to access additional contact information.
Accessibility Documents
Publications
Forms
| Title | Summary | Region | Last Modified | Category | File Type | File Size | Link | hf:doc_tags | hf:doc_categories | hf:file_type |
|---|---|---|---|---|---|---|---|---|---|---|
| Assessment & Service Plan Authorization Private/In-Home School – EN | Assessment service plan form – fillable | Erie St. Clair | July 8, 2024 | Forms | 895 KB | erie-st-clair | forms | |||
| BWH-ER Referral and Treatment Form – EN | Bluewater Water Health emergency referral and treatment form – fillable | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| BWH-Inpatient Referral and Treatment Form – EN | Bluewater Water Health inpatient referral and treatment form – fillable | Erie St. Clair | July 8, 2024 | Forms | 2 MB | erie-st-clair | forms | |||
| BWH-Outpatient Referral and Treatment Form – EN | Bluewater Water Health outpatient referral and treatment form – fillable | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| CHSS Referral Form Public Private – EN | Children’s Health School Services Program referral form – fillable | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| CHSS Referral Form Public Private FR | Children’s Health School Services Program referral form – fillable in French | Erie St. Clair | July 8, 2024 | Forms | 107 KB | erie-st-clair | forms | |||
| CKHA-ER Referral and Treatment Plan Form – EN | Chatham-Kent Health Alliance emergency referral and treatment form – fillable | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| CKHA-Inpatient Referral and Treatment Plan Form | Chatham-Kent Health Alliance inpatient referral and treatment form – fillable | Erie St. Clair | July 19, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| CKHA-Outpatient Referral and Treatment Form – EN | Chatham-Kent Health Alliance outpatient referral and treatment form – fillable | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| Electrical Stimulation (eSTIM) Non-Formulary Order Form | Electrical Stimulation (eSTIM) non-formulary order form – fillable | Erie St. Clair | July 8, 2024 | Forms | 605 KB | erie-st-clair | forms | |||
| Electrical Stimulation (eSTIM) Referral Assessment – EN | Electrical Stimulation (eSTIM) referral assessment form – fillable | Erie St. Clair | July 8, 2024 | Forms | 561 KB | erie-st-clair | forms | |||
| Equipment Rental Authorization Order Form – EN | Equipment rental authorization/order form – fillable | Erie St. Clair | July 8, 2024 | Forms | 338 KB | erie-st-clair | forms | |||
| ESHC-ER Referral and Treatment Form – EN | Erie Shores HealthCare emergency referral and treatment form – fillable | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| ESHC-Inpatient Referral and Treatment Form | Erie Shores HealthCare inpatient referral and treatment form – fillable | Erie St. Clair | July 19, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| ESHC-Outpatient Referral and Treatment Form – EN | Erie Shores HealthCare outpatient referral and treatment form – fillable | Erie St. Clair | July 9, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| Feeding Respiratory Suction Med. Equipment & Supplies Order Form | … | Erie St. Clair | July 25, 2024 | Forms | 909 KB | erie-st-clair | forms | |||
| First Dose Parenteral Screener (ESC) – EN | First dose parenteral screener form – fillable | Erie St. Clair | July 8, 2024 | Forms | 454 KB | erie-st-clair | forms | |||
| Formulaire de demande pour la divulgation de renseignements personnels | Formulaire de demande pour la divulgation de renseignements personnels. En vertu de la Loi de 2004 sur la protection des renseignements personnels sur la santé Veuillez | Central, Central East, Central West, Champlain, Erie St. Clair, Global, Hamilton Niagara Haldimand Brant, Mississauga Halton, North East, North Simcoe Muskoka, North West, South East, South West, Toronto Central, Waterloo Wellington | July 8, 2024 | Forms | 2 MB | central central-east central-west champlain erie-st-clair global hamilton-niagara-haldimand-brant mississauga-halton north-east north-simcoe-muskoka north-west south-east south-west toronto-central waterloo-wellington | forms | |||
| geko Device Eligibility Checklist & Assessment Tool – EN | … | Erie St. Clair | July 8, 2024 | Forms | 888 KB | erie-st-clair | forms | |||
| Guidelines for Provision of KCI VAC NPWT – EN | Guidelines for provision of KCI VAC negative pressure wound therapy | Erie St. Clair | July 8, 2024 | Forms, Guide | 783 KB | erie-st-clair | forms guide | |||
| HDGH-Inpatient Referral and Treatment Form | Hôtel-Dieu Grace Healthcare inpatient referral and treatment form – fillable | Erie St. Clair | July 19, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| HDGH-Inpatient Referral and Treatment Form – EN | Hôtel-Dieu Grace Healthcare inpatient referral and treatment form – fillable | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| Medical Supply Order Form – EN | … | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| Medical Update Request Form – EN | Medical update request form | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| Medical Update Request Form – Wound – EN | Medical update request form – wound | Erie St. Clair | July 8, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| Mental Health and Addictions Nurses (MHAN) e-Referral Form | Mental Health and Addictions Nursing Program Referral Form for School Board, Community Agencies, etc. | Erie St. Clair | July 26, 2024 | Forms | html | erie-st-clair | forms | html | ||
| Negative Pressure Wound Therapy – Supplies & Equipment Order Form | Office Location: 180 Riverview Dr, Chatham | Erie St. Clair | July 25, 2024 | Forms | 95 KB | erie-st-clair | forms | |||
| Negative Pressure Wound Therapy Referral Form | Note: NPWT will continue to be assessed in the community, and settings may be reviewed based on exudate and patient tolerance. Continuation of NPWT is dependent on wound healing goals being met. Maximum treatment time for NPWT is 8 weeks. | Erie St. Clair | July 15, 2024 | Forms | 105 KB | erie-st-clair | forms | |||
| Non-formulary Medical Equipment Order Form – EN | Non-formulary medical equipment order form – fillable | Erie St. Clair | July 8, 2024 | Forms | 605 KB | erie-st-clair | forms | |||
| Non-formulary Medical Supplies Order Form – EN | Non-formulary medical supplies order form – fillable | Erie St. Clair | July 8, 2024 | Forms | 180 KB | erie-st-clair | forms | |||
| Offloading Shoe Assessment Form – EN | Offloading assessment form – fillable | Erie St. Clair | July 8, 2024 | Forms | 390 KB | erie-st-clair | forms | |||
| Ostomy Consultation Report | … | Erie St. Clair | July 8, 2024 | Forms | 157 KB | erie-st-clair | forms | |||
| Ostomy Supply Order Form | Ostomy supply order form – fillable | Erie St. Clair | August 29, 2023 | Forms | 270 KB | erie-st-clair | forms | |||
| Providers Cupboard Usage – EN | Providers cupboard usage order form – fillable | Erie St. Clair | July 9, 2024 | Forms | 481 KB | erie-st-clair | forms | |||
| Referral and Treatment Form | Referral and treatment plan form – fillable | Erie St. Clair | July 9, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| Referral and Treatment Form – Pain Medication | Referral and treatment plan pain medication order form – fillable | Erie St. Clair | July 6, 2023 | Forms | 795 KB | erie-st-clair | forms | |||
| Replenishment Order Form – Nursing | Replenishment order form nursing – fillable | Erie St. Clair | July 6, 2023 | Forms | 187 KB | erie-st-clair | forms | |||
| Replenishment Order Form – WCS – EN | Replenishment order form WCS – fillable | Erie St. Clair | July 9, 2024 | Forms | 202 KB | erie-st-clair | forms | |||
| Request for Release of Personal Health Information | Request for Release of Personal Health Information under the Personal Health Information Protection Act, 2004 | Central, Central East, Central West, Champlain, Erie St. Clair, Global, Hamilton Niagara Haldimand Brant, Mississauga Halton, North East, North Simcoe Muskoka, North West, South East, South West, Toronto Central, Waterloo Wellington | July 8, 2024 | Forms | 2 MB | central central-east central-west champlain erie-st-clair global hamilton-niagara-haldimand-brant mississauga-halton north-east north-simcoe-muskoka north-west south-east south-west toronto-central waterloo-wellington | forms | |||
| Symptom Response Kit Request Order Form (Chatham and Sarnia ONLY) – EN | Symptom Response Kit (SRK) Request Order Form Chatham/Sarnia | Erie St. Clair | July 9, 2024 | Forms | 216 KB | erie-st-clair | forms | |||
| Symptom Response Kit Request Order Form (Windsor ONLY) – EN | Symptom Response Kit (SRK) Request Order Form Windsor | Erie St. Clair | July 9, 2024 | Forms | 278 KB | erie-st-clair | forms | |||
| Telehomecare Referral Form – EN | Telehomecare referral form – fillable | Erie St. Clair | July 9, 2024 | Forms | 716 KB | erie-st-clair | forms | |||
| Total Contact Casting Treatment and Assessment | Total contact casting treatment and assessment forms – fillable | Erie St. Clair | August 16, 2023 | Forms | 968 KB | erie-st-clair | forms | |||
| Walker Assessment Form – EN | Walker assessment eligibility form | Erie St. Clair | July 9, 2024 | Forms | 209 KB | erie-st-clair | forms | |||
| WRH Met Campus Outpatient Referral and Treatment Form – EN | Windsor Regional Hospital – Met Campus outpatient referral and treatment form – fillable | Erie St. Clair | July 9, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| WRH-Met Campus Outpatient URO Referral and Treatment Form | Windsor Regional Hospital – Met Campus outpatient URO referral and treatment form – fillable | Erie St. Clair | December 19, 2023 | Forms | 113 KB | erie-st-clair | forms | |||
| WRH-Met-ER Referral and Treatment Form – EN | Windsor Regional Hospital – Met Campus emergency referral and treatment form – fillable | Erie St. Clair | July 9, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| WRH-Met-Inpatient Referral and Treatment Form | Windsor Regional Hospital – Met Campus inpatient referral and treatment form – fillable | Erie St. Clair | July 19, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| WRH-Ouellette Campus Outpatient Referral and Treatment Form – EN | Windsor Regional Hospital – Ouellette Campus outpatient referral and treatment form – fillable | Erie St. Clair | July 9, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| WRH-Ouellette-ER Referral and Treatment Form – EN | Windsor Regional Hospital – Ouellette Campus emergency referral and treatment form – fillable | Erie St. Clair | July 19, 2024 | Forms | 1 MB | erie-st-clair | forms | |||
| WRH-Ouellette-Inpatient Referral and Treatment Form | Windsor Regional Hospital – Ouellette Campus inpatient referral and treatment form – fillable | Erie St. Clair | July 19, 2024 | Forms | 1 MB | erie-st-clair | forms |