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… may be obtained at your family physician/primary care office, local health unit, or community clinic. … VACCINATIONS Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For … Tetanus/Diphtheria vaccination. Those who are providing care to pregnant women and/or children should receive a Tdap …
1 CITY-WIDE HEALTH SCREEN FOR VISITING ELECTIVES Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: CPSO #: Phone: Email: Emergency Contact Person: Contacts P...
… may be obtained at your family physician/primary care office, local health unit, or community clinic. … Email: OHSS-medicalaffairs@lhsc.on.ca St. Joseph’s Health Care London Occupational Health and Safety Services P.O. Box … fellows. A 3rd dose/booster is required for those providing care at St Joseph’s Health Care London Mount Hope site, and …
1 CITY-WIDE HEALTH SCREEN FOR PROFESSIONAL STAFF/RESIDENTS/CLINICAL FELLOWS Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: CPSO #: Phone: Email: Emergency...
… may be obtained at your family physician/primary care office, local health unit, or community clinic. … Email: OHSS-medicalaffairs@lhsc.on.ca St. Joseph’s Health Care London Occupational Health and Safety Services P.O. Box … VACCINATIONS Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For …
1 CITY-WIDE HEALTH SCREEN FOR PROFESSIONAL STAFF/RESIDENTS/CLINICAL FELLOWS Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: CPSO #: Phone: Email: Emergency...
… may be obtained at your family physician/primary care office, local health unit, community clinic, or … fellows. A 3rd dose/booster is required for those providing care at St Joseph’s Health Care London Mount Hope site, and for all other sites a 3rd … may be obtained at your family physician/primary care office, local health unit, community clinic, or …
1 CITY-WIDE HEALTH SCREEN FOR VISITING ELECTIVES Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: CPSO #: Phone: Email: Emergency Contact Person: Contacts P...
… may be obtained at your family physician/primary care office, local health unit, community clinic, or … fellows. A 3rd dose/booster is required for those providing care at St Joseph’s Health Care London Mount Hope site, and for all other sites a 3rd … may be obtained at your family physician/primary care office, local health unit, community clinic, or …
1 CITY-WIDE HEALTH SCREEN FOR VISITING ELECTIVES Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: CPSO #: Phone: Email: Emergency Contact Person: Contacts P...
… may be obtained at your family physician/primary care office, local health unit, or community clinic. … VACCINATIONS Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For … Tetanus/Diphtheria vaccination. Those who are providing care to pregnant women and/or children should receive a Tdap …
1 CITY-WIDE HEALTH SCREEN FOR VISITING ELECTIVES Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: CPSO #: Phone: Email: Emergency Contact Person: Contacts P...
… may be obtained at your family physician/primary care office, local health unit, or community clinic. … Email: OHSS-medicalaffairs@lhsc.on.ca St. Joseph’s Health Care London Occupational Health and Safety Services P.O. Box … VACCINATIONS Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For …
CITY-WIDE HEALTH SCREEN FOR PROFESSIONAL STAFF/RESIDENTS/CLINICAL FELLOWS Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: CPSO #: Phone: Email: Emergency C...
… and Acellular Pertussis booster. If you are providing care to pregnant women and/or children, you should receive … is due. 7. Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For … Email: OHSS-medicalaffairs@lhsc.on.ca St. Joseph’s Health Care London St. Joseph’s Hospital Occupational Health and …
Revised 20160411 Page 1 of 4 GUIDELINES FOR COMPLETION OF CITY-WIDE HEALTH SCREEN FOR PROFESSIONAL STAFF/RESIDENTS/CLINICAL FELLOWS (MUST Provide Proof) Past LHSC/St. Josephs Record: Yes No Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/...
… and Acellular Pertussis booster. If you are providing care to pregnant women and/or children, you should receive … is due. 7. Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For … and Acellular Pertussis booster. If you are providing care to pregnant women and/or children, you should receive …
GUIDELINES FOR COMPLETION OF CITY-WIDE HEALTH SCREEN FOR VISITING ELECTIVES Revised 20160108 Page 1 of 4 (MUST Provide Proof) Past LHSC/St. Josephs Record: Yes No Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Na...
… may be obtained at your family physician/primary care office, local health unit, or community clinic. … Email: OHSS-medicalaffairs@lhsc.on.ca St. Joseph’s Health Care London Occupational Health and Safety Services P.O. Box … via local COVID-19 Vaccination Clinic Sites and primary care settings. Influenza (flu) Seasonal influenza …
1 CITY-WIDE HEALTH SCREEN FOR PROFESSIONAL STAFF/RESIDENTS/CLINICAL FELLOWS Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: CPSO #: Phone: Email: Emergency...
… may be obtained at your family physician/primary care office, local health unit, or community clinic. … via local COVID-19 Vaccination Clinic Sites and primary care offices. Influenza (flu) Seasonal influenza … VACCINATIONS Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For …
1 CITY-WIDE HEALTH SCREEN FOR VISITING ELECTIVES Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: CPSO #: Phone: Email: Emergency Contact Person: Contacts P...
… Tb skin tests are available from family physicians/primary care providers, local public health agencies, universities … test done before my start date? A Family physicians/primary care provider, community clinics, public health agencies, … Email: OHSS-medicalaffairs@lhsc.on.ca St. Joseph’s Health Care London Occupational Health and Safety Services P.O. Box …
MEDICAL AFFAIRS HEALTH SCREEN Q & AS Q Should I complete the health screening requirements prior to my start date? A Yes. Every effort should be made to complete and submit the health screen requirements prior to your start date. Failure to do so may result in a delay to beginning your employment or...
… Tb skin tests are available from family physicians/primary care providers, local public health agencies, universities … test done before my start date? A Family physicians/primary care provider, community clinics, public health agencies, … Email: OHSS-medicalaffairs@lhsc.on.ca St. Joseph’s Health Care London Occupational Health and Safety Services P.O. Box …
MEDICAL AFFAIRS HEALTH SCREEN Q & AS Q Should I complete the health screening requirements prior to my start date? A Yes. Every effort should be made to complete and submit the health screen requirements prior to your start date. Failure to do so may result in a delay to beginning your employment or...
… TB testing may be obtained at your family physician/primary care office, local health unit, or community clinic. … VACCINATIONS Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For … Tetanus/Diphtheria vaccination. Those who are providing care to pregnant women and/or children should receive a Tdap …
CITY-WIDE HEALTH SCREEN FOR VISITING ELECTIVES Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Name: Gender: Date of Birth (YYYY/MM/DD): Family Physician: Phone: Email: Emergency Contact Person: Contacts Phone: Prim...
… Institute Main Building Parkwood Institute Mental Health Care Southwest Centre All St. Joseph’s Staff and … to Occupational Health and Safety at St Joseph’s Health Care London Name: __ Signature: __ Date: __ Volunteers/Co-op … Institute Main Building Parkwood Institute Mental Health Care Southwest Centre All St. Joseph’s Staff and …
HEALTH REVIEW FORM VOLUNTEER CO-OP STUDENT POST SECONDARY STUDENT SPONSORED STUDENT Proof of immunization is required and includes any of the following: Vaccination records from yellow immunization cards, Immigration records, notes from a physicians office, copies of laboratory reports (titre levels...
… Institute Main Building Parkwood Institute Mental Health Care Southwest Centre All St. Joseph’s Staff and … to Occupational Health and Safety at St Joseph’s Health Care London Name: __ Signature: __ Date: __ Volunteers/Co-op … Institute Main Building Parkwood Institute Mental Health Care Southwest Centre All St. Joseph’s Staff and …
July 2019 HEALTH REVIEW FORM VOLUNTEER CO-OP STUDENT POST SECONDARY STUDENT SPONSORED STUDENT Proof of immunization is required and includes any of the following: Vaccination records from yellow immunization cards, Immigration records, notes from a physicians office, copies of laboratory reports (ti...
… Institute Main Building Parkwood Institute Mental Health Care Southwest Centre In order to fulfill the terms and … to Occupational Health and Safety at St Joseph’s Health Care London. Name: … Institute Main Building Parkwood Institute Mental Health Care Southwest Centre In order to fulfill the terms and …
February 2019 HEALTH REVIEW FORM Paid Staff Private Hire St. Josephs Mt. Hope Parkwood Institute Main Building Parkwood Institute Mental Health Care Southwest Centre In order to fulfill the terms and conditions of your employment offer, the following information must be provided to Occupation...
… Institute Main Building ☐ Parkwood Institute Mental Health Care ☐ Southwest Centre To fulfill the terms and conditions … to Occupational Health and Safety at St Joseph’s Health Care London. ☐ Provide proof of COVID-19 vaccine. ☐ Follow … Public Health recommendations and St. Joseph's Health Care London policies and processes related to COVID …
August 2021 HEALTH REVIEW FORM Paid Staff Private Hire St. Josephs Mt. Hope Parkwood Institute Main Building Parkwood Institute Mental Health Care Southwest Centre To fulfill the terms and conditions of your employment offer, the following information must be provided to Occupational Health a...
… and Acellular Pertussis booster. If you are providing care to pregnant women and/or children, you should receive … is due. 7. Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For … and Acellular Pertussis booster. If you are providing care to pregnant women and/or children, you should receive …
GUIDELINES FOR COMPLETION OF CITY-WIDE HEALTH SCREEN FOR VISITING ELECTIVES Revised 20160817 Page 1 of 4 (MUST Provide Proof) Past LHSC/St. Josephs Record: Yes No Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Na...
… and Acellular Pertussis booster. If you are providing care to pregnant women and/or children, you should receive … is due. 7. Hepatitis B It is recommended that all health care workers receive a course of Hepatitis B vaccine. For … and Acellular Pertussis booster. If you are providing care to pregnant women and/or children, you should receive …
GUIDELINES FOR COMPLETION OF CITY-WIDE HEALTH SCREEN FOR VISITING ELECTIVES Revised 20160817 Page 1 of 4 (MUST Provide Proof) Past LHSC/St. Josephs Record: Yes No Anticipated Start Date of Clinical Placement (YYYY/MM/DD): Anticipated End Date of Clinical Placement (YYYY/MM/DD): First Name: Last Na...