SUGGEST AN UPDATE



Please fill in the following information about your service. When you are finished click "Submit" at the bottom of the page. Your service will not appear immediately on the site. Champlainhealthline.ca will review the information submitted.





Service Name:
Name 1:   
Name 2:   
Name 3:   
Former Name:   
Contact Details: Main Phone:   
Toll-Free:   
TTY:   
Crisis:   
After Hours:   
Fax:   
Email:   
Website:   



Mailing Information: c/o:         Street Address: (if different)
Building:   
Address:   
City:   
Province:   
Postal Code:   
Room:
Intersection:
Accessibility:
Accessibility Notes:
Hours:
Type of hours:
Other type label:
Day of Week
Opens:
Closes:
 
Type Holiday Day of Week Opens Closes
Hours Notes:
 
Dates Available:



Executive: Name:   
Title:   
Organization:   
Phone:   
Email:   
Executive 2: Name:   
Title:   
Organization:   
Phone:   
Email:   



Public Contact: Name:   
Title:   
Organization:   
Phone:   
Email:   
Public Contact 2: Name:   
Title:   
Organization:   
Phone:   
Email:   
Service Description:
Meetings:






Funding:
Fees:
Application:
Eligibility / Target Population
Languages:



French
Language Note:
Area Served:
Year Established:
Legal Status:



Downloads:   
PDF documents to be included with a service profile can be emailed to edit@ontariohealthathome.ca (max. 500 kB in size)



YouTube Video #1 URL:   
Title:   
YouTube Video #2 URL:   
Title:   
YouTube Video #3 URL:   
Title:   



Categories:   
This service profile appears in the following categories:
      Acquired Brain Injury Rehabilitation
      Amputee Rehabilitation
      Foot Care - In-Home
      Musculoskeletal Rehabilitation
      Neurological Rehabilitation
      Pulmonary Rehabilitation
      Rehabilitative Care - Hospital-Based Outpatient Therapy
      Rehabilitative Care - Hospital-Based Specialized Clinics and Services
      Rehabilitative Care - Private Pay Clinics
      Rehabilitative Care Inpatient - Rehabilitation High-Intensity
      Spinal Cord Injury Rehabilitation
      Stroke



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Source Contact: Name:   
Title:   
Organization:   
Phone:   
Email:   
Comments:



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