Please submit this form when you have completed all the required learning modules. You must have JavaScript enabled to use this form. I acknowledge completion of the following mandatory modules (please check each module box completed) and agree to the required e-learning responsibilities listed below: Breaking Barriers - Your guide to understanding Accessibility Additional Precautions Behaviour Safety Alert System Emergency Colour Codes Honeywell Personal Staff Alert Device Operation Infection Control Core Competency: Hand Hygiene Fire Safety and Extinguishers Personal Staff Alert Device Operation Privacy and Confidentiality Routine Practices Workplace Violence Prevention First name Last name Date of birth Email Volunteer location St. Joseph's Hospital Mount Hope Centre for Long Term Care Parkwood Institute South West Centre for Forensic Mental Health Care This personal information is being collected under the authority of the Public Hospitals Act R.S.O. 1990, CHAPTER P.40 for the purpose of contacting the sender in response to an inquiry. If you have questions about the collection of this information, please contact Privacy and Freedom of Information, St. Joseph's Health Care London, 268 Grosvenor Street, London, ON,519-646-6100 ext. 65591.
