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Program Information
Forms and Reference
Physician Information
Upcoming Education Sessions
CAPCE e-Learning
Fundamentals e-Learning
• Palliative Common Referral Form
• Update CRF Form
• FAQ
• Expected Death in The Home Form
• LTCH Referral Form
Palliative Symptom Relief Kit (SRK) Prescription Hospice Palliative Care Teams for Central LHIN
• Electronic version - complete on screen, printed and fax
• Symptom Management Kit Form for Temmy Latner Centre for Palliative Care Only
Stronach Regional Cancer Centre (for internal use at Southlake Regional Health Centre/SRCC)
• HPC Teams for Central LHIN Referral Form
Do Not Resuscitate Confirmation
• DNRC Form
• DNRC Ordering Information
Guidelines
• EDITH Protocol Guidelines For Implementation
• Symptom Relief Kit Guidelines For Implementation
• Central LHIN Early Identification and Prognostic Indicator Guide
Assessment Tools
• Edmonton Symptom Assessment System (ESAS) - Tool
• Description of Use of ESAS Tool
• Edmonton Symptom Assessment System (ESAS) - Albanian
• Edmonton Symptom Assessment System (ESAS) - Algonquin
• Edmonton Symptom Assessment System (ESAS) - Arabic
• Edmonton Symptom Assessment System (ESAS) - Armenian
• Edmonton Symptom Assessment System (ESAS) - Chinese
• Edmonton Symptom Assessment System (ESAS) - Cree
• Edmonton Symptom Assessment System (ESAS) - Estonian
• Edmonton Symptom Assessment System (ESAS) - Farsi
• Edmonton Symptom Assessment System (ESAS) - Finnish
• Edmonton Symptom Assessment System (ESAS) - German
• Edmonton Symptom Assessment System (ESAS) - Greek
• Edmonton Symptom Assessment System (ESAS) - Hindi
• Edmonton Symptom Assessment System (ESAS) - Hungarian
• Edmonton Symptom Assessment System (ESAS) - Inuktitut (Eastern Arctic Dialect)
• Edmonton Symptom Assessment System (ESAS) - Italian
• Edmonton Symptom Assessment System (ESAS) - Japanese
• Edmonton Symptom Assessment System (ESAS) - Korean
• Edmonton Symptom Assessment System (ESAS) - Oji Cree
• Edmonton Symptom Assessment System (ESAS) - Polish
• Edmonton Symptom Assessment System (ESAS) - Portuguese
• Edmonton Symptom Assessment System (ESAS) - Punjabi
• Edmonton Symptom Assessment System (ESAS) - Russian
• Edmonton Symptom Assessment System (ESAS) - Serbo/Croatian
• Edmonton Symptom Assessment System (ESAS) - Somali
• Edmonton Symptom Assessment System (ESAS) - Spanish
• Edmonton Symptom Assessment System (ESAS) - Tagalog
• Edmonton Symptom Assessment System (ESAS) - Turkish
• Edmonton Symptom Assessment System (ESAS) - Ukrainian
• Edmonton Symptom Assessment System (ESAS) - Urdu
• Edmonton Symptom Assessment System (ESAS) - Vietnamese
• Palliative Performance Scale (PPS) - Tool
• Description of Use of PPS Tool
• Palliative Performance Scale (PPS) - French
• Palliative Performance Scale (PPS) - Japanese
• Palliative Performance Scale (PPS) - Thai
Cancer Care Ontario (CCO)
Collaborative Care Plans (October 2009)
• Collaborative Care Plan - Stable
• Collaborative Care Plan - Transitional
• Collaborative Care Plan - End of Life
• Collaborative Care Plan - Pain
• Collaborative Care Plan - Dyspnea
• Collaborative Care Plan - Fatigue
• Collaborative Care Plan - Condensed
• Collaborative Care Plan - Resource Manual
Symptom Management Guides (Jan 2013)
• Guide to Practice - Loss of Appetite
• Pocket Guide - Loss of Appetite
• Algorithm - Loss of Appetite
• Guide to Practice - Bowel Care
• Pocket Guide - Bowel Care
• Algorithm - Constipation
• Algorithm - Diarrhea
• Guide to Practice - Depression Anxiety
• Algorithm - Anxiety
• Algorithm - Depression
• Guide to Practice - Fatigue
• Guide to Practice - Oral Care
• Pocket Guide - Oral Care
• Algorithm - Dysgeusi
• Algorithm - Infections
• Algorithm - Mucositis
• Algorithm - Xerostomia
• Guide to Practice - Pain
• Pocket Guide - Pain
• Algorithm - Pain
• Guide to Practice - Dyspnea
• Pocket Guide - Dyspnea
• Algorithm - Dyspnea
• Guide to Practice - Nausea & Vomiting
• Pocket Guide - Nausea & Vomiting
• Algorithm - Nausea & Vomiting
• Guide to Practice - Delirium
• Pocket Guide - Delirium
• Algorithm - Delirium
• Combined Delirium, Dyspnea, Nausea & Vomiting and Pain - Pocket Guide
• Algorithm - Sleep Disturbances
Reference
• A Caregivers Guide - End of Life Care
• Financial Assistance for Funerals, Burials, and Cremations
• The Last Hours or Days of Life
• Methadone For Cancer Pain
• Square of Care
• SBAR - template
• SBAR - Directions for Use
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