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Submit a Listing
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2024-04-30T21:50:55+00:00
Submit a Listing
Organization Name
*
Website
Type of organisation / service provider
Acute Care Hospital
Chronic / Long Term Care Facility
Dedicated Hospice Palliative Care Unit
Hospice Society
Non-profit Organization / Health Charity
Nursing Home or skilled Nursing Facility
Out-Patient Care / Clinic
Private Clinic / Service Provider
Hospice Residence
Address
Street Address
Address 2
City
*
Province
*
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Contact
Contact Name
*
Email
*
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Phone Number
*
Toll Free
Fax Number
Social Media
Facebook
Twitter
YouTube
Instagram
LinkedIn
What languages are your services offered in?
What languages are your services offered in?
English
French
Other (please specify)
Other Language
*
What age group does your organization/service currently serve?
What age group does your organization/service currently serve?
Adults
Children (0-18)
All Ages
Your organization/service provides support and/or care for the following health needs : (please check all that apply):
Your organization/service provides support and/or care for the following: (please check all that apply).
All conditions
Anticipatory Grief and Bereavement
Cancer
Cardiovascular Disease
Emotional/Spiritual Support
Infectious Diseases (ie HIV/AIDS, Hepatitis-C)
Neurological Disorders
Renal Disease
Respiratory Disease
Other support and/or care provided
*
Your organization/service provides the following: (please check all that apply)
Your organization/service provides the following: (please check all that apply)
Bereavement Support
Child and Youth Specific Programs
Clinical Counselors
Complementary Therapies
Day Program
Dietitians
Education
Home Support (Homemaking)
Nurses
Occupational Therapists
Other Complementary Services / Therapies
Pain Symptom Management
Physicians
Physiotherapists
Respite Care
Social Workers
Speech/Language Therapists
Spiritual/Pastoral Support
Volunteer Coordinators
Other services provided
*
Bed Information
Number of Hospice Palliative care Beds
Please enter a number from
0
to
500
.
More
Details
Name
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