North West area

North West Area Office Locations

  • Thunder Bay
    961 Alloy Drive
    Thunder Bay, ON, P7B 5Z8
  • Kenora – By Appointment Only
    3-35 Wolsley Avenue
    Suite #3
    Kenora, ON, P9N 0H8
  • Dryden – By Appointment Only
    6-61 King Street
    Dryden, ON, P8N 1B7
  • Fort Frances – By Appointment Only
    110 Victoria Avenue
    Fort Frances, ON, P9A 2B7

Compliments and Concerns?

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

Email: nwpatientrelations@ontariohealthathome.ca

Toll Free: 1-800-626-5406 Ext. 2283

Mail: Ontario Health atHome Compliments and Concerns
Attn: Patient Relations
961 Alloy Drive
Thunder Bay, ON
P7B 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.

Forms

TitleSummaryRegionLast ModifiedCategoryFile TypeFile SizeLinkhf:doc_tagshf:doc_categorieshf:file_type
Adult Infusion Therapy Intravenous Remdesivir Referral Form

Referral form for administering COVID-19 antivirals in North West community.

January 4, 2024pdf562 KBnorth-westformspdf
Application for Determination of Eligibility for LTC

Instructions

Form provided by the Ministry of Long-Term Care under the Fixing Long-Term Care Act, 2021.

If you wish to be admitted to a long-term care (LTC) home, you must fill out this form. This information is required by Ontario Health atHome, the designated placement co-ordinator for LTC homes, to determine if you are eligible for admission. Ontario Health atHome may collect additional personal health information from your health care providers
for the purpose of determining your eligibility. Ontario Health atHome may also use and disclose the information for the same purpose.

, , , , , , , , , , , , , April 1, 2025pdfcentral 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-centralformspdf
COPD and Heart Failure Telehomecare Referral Form

September 17, 2022pdf867 KBnorth-westformspdf
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 29, 2024pdf251 KBnorth-westformspdf
Demande de détermination de l’admissibilité à l’admission à un foyer de soins de longue durée

Instructions

Formulaire fourni par le ministère des Soins de longue durée en vertu de la Loi de 2021 sur le redressement des soins de longue durée.

Si vous souhaitez être admis dans un foyer de soins de longue durée (SLD), vous devez remplir ce formulaire. Ces renseignements sont requis par Santé à domicile Ontario, le coordonnateur du placement désigné pour les foyers de SLD, afin de déterminer si vous êtes admissible à l’admission. Santé à domicile Ontario peut recueillir d’autres renseignements personnels sur la santé auprès de vos fournisseurs de soins de santé afin de déterminer votre admissibilité. Santé à domicile Ontario peut également utiliser et divulguer les renseignements aux mêmes fins.
Renseignements sur le demandeur

, , , , , , , , , , , , , , April 1, 2025pdfcentral 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
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
Home I.V. Therapy

To ensure that your patient receives I.V. therapy in a timely and efficient manner, be sure to complete ALL areas on this referral form. 24 hour notice may be required depending on availability of the drug, supplies and/or service provider.

April 10, 2024pdf358 KBnorth-westformspdf
Mental Health and Addiction Nurse Referral Form – English

September 17, 2022pdf169 KBnorth-westformspdf
Mental Health and Addiction Nurse Referral Form – français

September 17, 2022pdf185 KBnorth-westformspdf
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 15, 2024pdf87 KBnorth-westformspdf
Palliative Symptom Management Kit Order Form

Palliative Symptom Management Kit Order Form, North West

December 11, 2023pdf123 KBnorth-westformspdf
Referral for Ontario Health atHome Services

Referral for Ontario Health atHome Services in North West

June 29, 2024pdf410 KBnorth-westformspdf
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