Erie St. Clair

Information and Referral

310-2222

(No area code required)

Toll-free:1-888-447-4468
TTY:519-258-8092
esc.engagement@hccontario.ca

IMPORTANT: DO NOT send any personal health information. This email is not for patient feedback or referrals. Please call us directly at the numbers listed above. We aim to respond within 72 hours, however, this email account is not checked on weekends or statutory holidays.

Visit Erie St. Clair Healthline

Erie St.

Erie St. Clair Office Locations

  • Chatham (Corporate Office)
    180 Riverview Drive,
    Chatham, ON, N7M 5Z8
    Fax:  Chatham-Kent – 519-351-5842
  • Chatham Clinic
    462 Riverview Drive
    Chatham, ON, N7M 0N2
  • Sarnia Office & Clinic
    1150 Pontiac Drive,
    Sarnia, ON, N7S 3A7
    Fax:  Sarnia-Lambton: 519-337-4331
  • Windsor Office & Clinic
    5415 Tecumseh Road, East,
    Windsor, ON, N8T 1C5
    Fax:  Windsor-Essex: 519-258-6288

Compliments and Concerns?

Please share your feedback with your care coordinator. You may also share compliments or concerns in the following ways:

Email: jenna.martin@hccontario.ca​​​

Phone: 1-888-447-4468 ext. 5378

Mail: Home and Community Care Support Erie St. Clair Compliments and Concerns
Attn: Patient Relations Specialist
180 Riverview Drive
Chatham, ON N7M 5Z8

Newsroom and Media Relations

Visit our newsroom for more information on news and events. 

For all media-related enquiries, please contact HCCSSmedia@hccontario.ca.

For non-media-related enquiries about Home and Community Care Support Services and to serve you best, please visit the Contact Us page to access additional contact information.

Forms

TitleSummaryRegionLast ModifiedCategoryFile TypeFile SizeLinkdoc_tags_hfilterdoc_categories_hfilterfile_type_hfilter
Assessment & Service Plan Authorization Private/In-Home School

September 16, 2022pdf835 KBerie-st-clairformspdf
BHW-Inpatient Referral and Treatment Form

September 16, 2022pdf2 MBerie-st-clairformspdf
BWH-ER Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
BWH-Outpatient Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
CHSS Referral Form Public Private

September 16, 2022pdf1 MBerie-st-clairformspdf
CHSS Referral Form Public Private French

September 20, 2022pdf129 KBerie-st-clairformspdf
CKHA-ER Referral and Treatment Plan Form

September 16, 2022pdf1 MBerie-st-clairformspdf
CKHA-Inpatient Referral and Treatment Plan Form

September 16, 2022pdf1 MBerie-st-clairformspdf
CKHA-Outpatient Referral and Treatment Form

September 16, 2022pdf2 MBerie-st-clairformspdf
Diabetes Education Referral Form

September 16, 2022pdf59 KBerie-st-clairformspdf
Electrical Stimulation (eSTIM) Non-Formulary Order Form

September 16, 2022pdf700 KBerie-st-clairformspdf
Electrical Stimulation (eSTIM) Referral Assessment

September 16, 2022pdf383 KBerie-st-clairformspdf
Equipment Rental Authorization Order Form​

September 16, 2022pdf221 KBerie-st-clairformspdf
ESHC-ER Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
ESHC-Inpatient Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
ESHC-Outpatient Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
Feeding Respiratory Suction Med. Equipment & Supplies Order Form

September 16, 2022pdf826 KBerie-st-clairformspdf
geko Device Eligibility Checklist & Assessment Tool

September 16, 2022pdf826 KBerie-st-clairformspdf
HDGH-Inpatient Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
Medical Supply Order Form

September 16, 2022pdf1 MBerie-st-clairformspdf
Medical Update Request Form

September 16, 2022pdf1 MBerie-st-clairformspdf
Medical Update Request Form – Wound​

September 16, 2022pdf1 MBerie-st-clairformspdf
Mental Health and Addictions Nurses for Youth Form

September 16, 2022pdf1 MBerie-st-clairformspdf
MHAN e-Referral Form

October 4, 2022htmlerie-st-clairformshtml
MHAN Self-Referral Form

October 4, 2022htmlerie-st-clairformshtml
Negative Pressure Wound Therapy

September 16, 2022pdf208 KBerie-st-clairformspdf
Negative Pressure Wound Therapy – Referral Assessment

September 16, 2022pdf5 MBerie-st-clairformspdf
Non-formulary Medical Equipment Order Form

September 16, 2022pdf713 KBerie-st-clairformspdf
Non-formulary Medical Supplies Order Form

September 16, 2022pdf96 KBerie-st-clairformspdf
Offloading Shoe Assessment Form

September 16, 2022pdf359 KBerie-st-clairformspdf
Ostomy Consultation Report

September 16, 2022pdf270 KBerie-st-clairformspdf
Ostomy Supply Order Form

September 16, 2022pdf221 KBerie-st-clairformspdf
Providers Cupboard Usage

September 16, 2022pdf396 KBerie-st-clairformspdf
Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
Referral and Treatment Form – Pain Medication

September 16, 2022pdf795 KBerie-st-clairformspdf
Replenishment Order Form – Nursing

September 16, 2022pdf187 KBerie-st-clairformspdf
Replenishment Order Form – WCS​

September 16, 2022pdf178 KBerie-st-clairformspdf
Telehomecare Referral Form​​​

September 16, 2022pdf618 KBerie-st-clairformspdf
Total Contact Casting Treatment and Assessment

September 16, 2022pdf968 KBerie-st-clairformspdf
Walker Assessment Form

September 16, 2022pdf132 KBerie-st-clairformspdf
WRH-Met-ER Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
WRH-Met-Inpatient Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
WRH-Met-Outpatient URO Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
WRH-Met-Outpatient URO Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
WRH-Ouellette-ER Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
WRH-Ouellette-Inpatient Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf
WRH-Ouellette-Outpatient Referral and Treatment Form

September 16, 2022pdf1 MBerie-st-clairformspdf