Mississauga Halton area

Mississauga Halton Area Office Locations

  • Mississauga
    2655 North Sheridan Way, Suite 140
    Mississauga, ON, L5K 2P8
  • Etobicoke
    401 The West Mall, Suite 900
    Etobicoke, ON, M9C 5J5
  • Milton
    611 Holly Avenue, Unit 203
    Milton, ON, L9T 0K4

Compliments and Concerns?

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

Email: mhpatient.relations@ontariohealthathome.ca

Phone: 416-780-7883

Mail: Ontario Health atHome
Patient Relations Office
401 The West Mall, Suite 900
Etobicoke, ON M9C 5J5

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.

Forms

TitleSummaryRegionLast ModifiedCategoryFile TypeFile SizeLinkhf:doc_tagshf:doc_categorieshf:file_type
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

, , , , , , , , , , , , , , September 19, 2024pdf229 KBcentral 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-wellingtonformspdf
Long-Term Care Health Assessment Form

October 5, 2022pdf2 MBmississauga-haltonformspdf
MHAN Referral Form

Mental Health and Addictions Nursing Program Referral Form

June 28, 2024pdf553 KBmississauga-haltonformspdf
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.

July 12, 2024pdf88 KBmississauga-haltonformspdf
Negative Pressure Wound Therapy Supplies Order Form

Fax: 905-855-8989 / 1-877-298-8989
*Hospital: Use hospital Ontario Health atHome fax number

August 12, 2024pdf242 KBmississauga-haltonformspdf
Palliative Care Services Referral Form

Mississauga Halton referral form for palliative services and palliative care nurse practitioner services for adults

June 28, 2024pdf298 KBmississauga-haltonformspdf
Referral Form

Note: To ensure patient safety and care continuity, please complete this Referral Form in full. Palliative referrals are to use the Palliative Care Services Referral Form available at ontariohealthathome.ca

June 28, 2024pdf133 KBmississauga-haltonformspdf
Request for Release of Personal Health Information

Request for Release of Personal Health Information under the Personal Health Information Protection Act, 2004

, , , , , , , , , , , , , , September 19, 2024pdf2 MBcentral 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-wellingtonformspdf
Symptom Management Kit Prescription/Order Form

Mississauga Halton Symptom Management Kit Prescription/Order Form

June 28, 2024pdf154 KBmississauga-haltonformspdf