About Patient Services

Complex Continuing Care

Rehabilitation and Community Living

Long Term Care

Admitting Forms

Patient Email

Info for Referring Professionals

If you are a referring professional and want more information on the services we provide, please visit our Information for Referring Professionals page to download a free copy of our 2006 Directory of Services. For additional information on rehabilitation services in the GTA, including admission criteria and wait list information, visit the GTA Rehab Network’s Rehab Finder web site.

Admission/Referral Forms and Applications

For your convenience, we have made available for download a selection of OHA and West Park Admission/Referral Forms and Applications on our web site as PDF files. These forms must be printed, completed and signed by a referring physician and faxed back to our Admitting Department at (416) 243-8947.

If you require any assistance in filling out a particular form or need further information regarding admission to West Park, please call (416) 243-3626.

1. Request for Service Form
This must be submitted along with the Required OHA Supporting Medical Assessment and Information Forms available below.

2. Supporting Medical Assessment and Information Forms
This document includes a request-for-service form, applicant identification, medical assessment and referral, functional assessment and care requirement and applicant’s social information

3. Geriatric Functional Enhancement Service Inpatient Referral Form
This pre-admission assessment form must accompany the Ontario Hospital Association request for service application to determine eligibility for this service.

4. TB Service Inpatient Referral/Application Form
Please download this form and contact the TB Service directly at (416) 243-3600, ext. 4054.

5. NEW! Photography Consent Form
In an effort to ensure safe patient medication administration, West Park Healthcare Centre would like to use a photograph as visual confirmation of patient identity. Please download this form and submit with admitting/referral forms.