Ontario Specific
Drivers Medical Form
A two sided drivers physical form that is acceptable for the Ministry of Transportation. Upload the CSS and PNG files to the images folder. Upload the HTML file as a eform
OHIP Patient enrolment and consent form
From Ian Pun: I also wrote an eForm that prints the patient info for the PATIENT ENROLMENT AND CONSENT TO RELEASE PERSONAL INFORMATION FORM for rostering patients . Saves time in having the patient fill it out themselves. They just need to sign. Email me if you want it. ---- Ian Pun----- and---- Here's the Patient Enrolment and Consent eForm html - just copy it into the eform code editor There is no background to this. OHIP wants original forms so you have to print on the original forms provided by them. Tear the original triplicate carbon copy Patient Enrolment form into the three separate sheets - white , yellow and pink. Put them in your manual feed of your laser printer. Print three copies. (no borders, no URL's etc), One for OHIP , one for your patient and one for your paper chart (or scanner). My Brother Laser HL5250 (I have 7) can take all sorts of this abuse. Other printers may rip the thin paper to shreds. Not perfect. I could not get the laser printer to print right at the bottom of the page where the phone numbers are. I didn't work on the child part one yet.
Accessible Parking Permit
A two page form to fill to allow access to designated "handicapped" parking spots in Ontario
Do Not Ressusitate
Ontario DNR form. Caveat, you need to supply an unique serial number to the form (eg take one from a paper one and destroy the paper)
Smoking Cessation Flowsheet
Helpful to document smoking cessation management and eligiblity to charge Ontario smoking cessation fee codes Q041A and Q042A Draws smoking status from the echart
4768 CCAC Health Assessment Report 2010
5 page eForm required to bill K038 for application to nursing homes and long term care. Turns a tedious task into one which fills itself from the chart.
4406 Nonformulary Exceptional Access Program (Section 8) 2009
Application for coverage under Ontario Drug Benefit for a "Section 8" type coverage for a non formulary drug,
Medical Condition Report to the MOT
A eForm to report a drivers medical condition to the Ontario Ministry of Transportation for them to review the drivers license K035
Ontario Lab eForm
By Peter HC - Spurned by a change at the ministry of their lab forms last November. Comes with decision support that gently alerts you to both overdue indicated investigations as well as those that have been done recently.
