Hematology Team. Name: Your JCC Chart #:

Similar documents
Pain and Symptom Management Clinic

Emergency Care for Blood and Marrow Transplant Patients

PATIENT REGISTRATION FORM

PATIENT INFORMATION SHEET:

Regulation STUDENTS August 13, Management of Students with Cancer in the School Setting

What to Expect If you need care

Please bring your ID and Medical/Dental Insurance cards to all appointments PATIENT REGISTRATION PATIENT INFORMATION. Cell Phone ( ) Employer s Name

UW MEDICINE PATIENT EDUCATION. Right Heart Catheterization. How to prepare and what to expect DRAFT. Your Appointment

Radiation Oncology. This guide was prepared by the nursing staff of the JGH and the volunteers of Hope & Cope.

PATIENT INFORMATION. Address: Sex: City: State: address: Cell Phone: Home Phone: Work Phone: address: Cell Phone:

Family Handbook. New Diagnosis Guide. Provided through the generosity of

UW MEDICINE PATIENT EDUCATION. Angiography: Radiofrequency Ablation to Treat Solid Tumor. What to expect. What is radiofrequency ablation?

Last Name First Middle. Mailing Address. City State Zip Phone. Date of Birth Age Soc. Sec# Cell. Employer Work Phone

Infusion Treatment A Patient s Guide

Patient s Full Name DOB Age. Patient s SSN Sex: Male Female Preferred Language. Place of Birth: City State Country

Please bring with you

Brachytherapy: High Dose Rate (HDR) Radiation Interstitial Implant

What You Need to Know About Your Nephrostomy Tube

TOTAL HIP REPLACEMENT FLOW SHEET

PATIENT AGREEMENT TO SYSTEMIC ANTI- CANCER THERAPY:

Naturopathic Wellness Center

Day Surgery at Toronto General Hospital

PARTICIPANT HANDBOOK. City and County of San Francisco Department of Public Health Updated February 2017

PATIENT AGREEMENT TO SYSTEMIC ANTI- CANCER THERAPY:

Pediatric New Patient Form

WITHOUT YOUR WRITTEN CONSENT, WE CAN NOT SPEAK TO ANYONE REGARDING YOUR MEDICAL CARE due to privacy laws. You have the right to list anyone you

Radiofrequency Ablation to Treat Solid Tumors

A Patient s Guide to Surgery

Transjugular Liver Biopsy About your procedure

UW MEDICINE PATIENT EDUCATION. Angiography: Kidney Exam. How to prepare and what to expect. What is angiography? DRAFT. Why do I need this exam?

PATIENT INFORMATION (Please Print)

A Patient s Guide to Surgery

ANTICOAGULATION MANAGEMENT SERVICE PATIENT AND FAMILY EDUCATION

Columbia Gorge Heart Clinic 1108 June St. Appointment date/time Hood River, OR fax Physician

COLON & RECTAL SURGERY, INC.

Pediatric Patient History

Welcome to the Juravinski Cancer Centre. Patient and Family Handbook

New Patient Paperwork

Julie Gussenhoven, OD 3416 Bechelli Lane Redding, CA 96002

PATIENT SAFETY PART OF THE JOINT COMMISSION SPEAK UP PROGRAM

About Your Colectomy

TRINITY DENTAL CLINIC Medical History Form Date:

Patient s Legal Name: Preferred Name: First Middle Last

Cobimetinib (Cotellic ) ( koe-bi-me-ti-nib )

The Urgent Care Center at MSK

ANTICOAGULATION MANAGEMENT SERVICE PATIENT AND FAMILY EDUCATION

Know what to expect when having a feeding tube inserted as an outpatient

An EPO Employee and Retiree Medical Plan...

School Based Health Consent for Services Grace Community Health Center, Inc.

UW MEDICINE PATIENT EDUCATION. Angiography: Percutaneous or Transjugular Liver Biopsy. How to prepare and what to expect. What is a liver biopsy?

Understanding Health Care in America An introduction for immigrant patients

ANTICOAGULATION MANAGEMENT SERVICE PATIENT AND FAMILY EDUCATION

STUDENT-OVER THE COUNTER MEDICATIONS FORM SUMMER 2016

223Radium Xofigo. Information for patients and families

Your Anesthesiologist, Anesthesia and Pain Control

Surgical Associates of Central FL, PA 1181 Orange Avenue Winter Park, FL

Care of Your Peripherally Inserted Central Catheter

A B O U T M E A B O U T M E. I n t h i s s e c t i o n, y o u w i l l f i n d : Your important contacts. Your medical history

Thoracic surgery medicines

What You Need to Know about Your PTCD

Welcome to C4 Hematology

PATIENT INFORMATION INSURANCE INFORMATION

Welcome to Rehabilitation Information for patients and families

General Information about radiotherapy

Patient Name: Last First Middle

Hello and Welcome! I truly look forward to working with you and your child on the journey towards optimal health. Warmly, Amanda H.

PATIENT AGREEMENT TO SYSTEMIC ANTI- CANCER THERAPY:

Oxfordshire Anticoagulation Service. Important information about anticoagulation with vitamin K antagonists Information for patients

New Patient Registration Form NJR_NP_F100

Welcome and thank you for choosing Jerman Family Dentistry

A PATIENT S GUIDE TO UNDERSTANDING ADVANCE HEALTH CARE DIRECTIVES. By Maureen Kroning EdD, RN

MRI (Magnetic Resonance Imaging) Core Breast Biopsy

Patient Information Booklet. Appointments

Caring for Your Child Radiation Treatment with General Anesthesia

PLASTIC SURGERY ASSOCIATES OF LEHIGH VALLEY MEDICAL HISTORY QUESTIONNAIRE (MR: )

HEALTH CHECK WHO NEEDS A WELL CHILD CHECK-UP? Office of Healthcare Financing. What is included in a well child health check?

2200 Northern Boulevard, Suite 133 East Hills, NY Fax (516) Transitional Care

2201 Murphy Avenue, Suite 307 Nashville, TN Phone Fax Date. Patient s Full Name

UW MEDICINE PATIENT EDUCATION. What is Yttrium-90 radiotherapy? DRAFT. Why do I need this treatment? How does Y-90 radiotherapy work?

Frequently Discussed Topics

Chemotherapy services at the Cancer Centre at Guy s

Cardiovascular Intensive Care Unit (CVICU)

Patient Name First Middle Last Address Street City State Zip Home Phone Work Phone Cell Phone. Date of Birth SS#

Tennessee Neurology Specialists Affiliated with Baptist Healthcare Group

CUSTOMER SERVICE MEMBER FOCUS A NEW WAY TO REACH. Hawai i 2017 Issue I NUMBERS TO KNOW

Your Anesthesiologist, Anesthesia and Pain Control

Welcome to Pinnacle Chiropractic Spine and Sports Center

Whipple Procedure (Pancreaticoduodenectomy)

Welcome to Pinnacle Chiropractic Spine and Sports Center

4343 N. Josey Lane Carrollton, TX BSWHealth.com/Carrollton. A Patient s Guide to Surgery

DOUGLAS JAY SPRUNG MD, FACG, FACP The Gastroenterology Group

Norman H. Anderson M.D., P.A. Robert Boissoneault Oncology Institute INSURANCE AUTHORIZATION

Spouse's Work ( ) Best time and place to reach you _ IN CASE OF EMERGENCY, CONTACT (Specify someone who does not live in your household.

Introduction to Day Hospital

You will be having surgery to remove a the distal or tail part of your pancreas.

PATIENT INFORMATION. Patient s Name: Birthdate: ( ) F ( ) M LAST FIRST MI. ( ) Married ( ) Single ( ) Divorced ( ) Separated ( ) Widowed Occupation:

EMPOWERING YOU a guide for caregivers. Tom D. EMPLICITI caregiver I ll always provide help, love, and support

UW MEDICINE PATIENT EDUCATION. How to prepare and what to expect DRAFT. What is an IVC filter?

STANDARDIZED PROCEDURE ALLOGENEIC /AUTOLOGOUS HEMATOPOIETIC STEM CELL INFUSION (Adult, Peds)

Transcription:

Name: Your JCC Chart #: During your care at the Juravinski Hospital and Cancer Centre you will meet many health care providers. Today, you met a nurse and doctor (hematologist) who are your Primary Team. They will follow your health during and after treatment with regular clinic visits. During your clinic visits, your Primary Team will: do medical checks arrange tests as needed address your concerns and questions Your care may also take place in the Juravinski Hospital: Oncology Day Services (ODS), on B4 Hematology Unit, on C4 If you are not feeling well If you are not feeling well, please do not wait to call. If it is not urgent, call during office hours. It is important to call the office early in the day so you can be seen in the clinic during office hours or in the hospital. A nurse will return your call as soon as possible. A hematologist is available for emergency calls outside of office hours.

2 Hematology Team Call your Primary Hematology Team Monday to Friday, 9:15 am to 4:30 pm. Your call will go to the Hematology Office. Please include: the spelling of the patient s full name chart number or date of birth detailed reason for your call your contact information (phone number) Important: In order for a message to be left you must have an answering machine that identifies your name or phone number for a message to be left. After hours call: 905-387-9495 After hours and on weekends and holidays a hematologist is available for urgent calls only. If you have to call after hours or on weekends please have as much information about your illness and current problems as possible. The hematologist on-call may not have your records nearby.

3 When to call If, during chemotherapy or receiving radiation treatments, you have a fever you must call your hematologist right away. Do not ignore a fever. A fever is a temperature of 38 o C (100 o F) or more. Do not take Tylenol, Aspirin, ibuprofen or any other anti-inflammatory medication without checking with your team first. They may cause bleeding and may hide a fever. Call if you need medication for pain. Please call if you have problems with: sudden or easy bleeding or bruising extreme fatigue shortness of breath diarrhea lasting more than 48 hours a decrease in the amount of urine you have burning on urination blood in the urine a productive cough a sore throat or mouth Call 911 or go to the Emergency Department if you are very short of breath or have severe chest pains. Test and lab results We understand that waiting for test and lab results is difficult, but we feel it is important to discuss the results in person. We do not give lab and test results over the phone. Unless you were asked to call, please do not call the clinic for your results. Family doctor We will keep your family doctor informed about your health by sending a letter after each visit. It may take 2 weeks for this letter to be received. Patient and Family handbook Please read the Patient and Family handbook in your JCC welcome bag. The handbook provides information on how to prepare yourself for care and treatment when coming to the JCC. please turn over

Medications Bring all of your current medications including herbal and vitamins with you in their original containers to each appointment. Your hematologist will prescribe new medications as needed. Any prescriptions by your family doctor or other specialists must be reordered by them. If you need a prescription reordered before any appointment at the JCC, please call your pharmacy. Allow at least 2 business days for a prescription to be filled. Medical forms and letters There may be a time when you need a signed form from your doctor. If you need this, please complete your section of the form and sign it before bringing the form to your clinic visit. You will need to sign a release of information consent form in order for your doctor to complete the medical form. Due to Ontario Privacy Laws, forms cannot be completed and returned to you on the same day. Your form will be completed as soon as possible. Please include a signed note with your form telling us whether you would like to be called to pick it up or where you would like it mailed. If someone is picking up the form for you, they must have a written permission note to do so. If you have any questions about the status of your form, please call the Release of Information Office at 905-387-9495, ext. 63315 or ext. 63324. You may have to pay a fee for this service. PD 5887 01/2018 dpc/pted/hematologyteamjcc-th.docx dt/january 9, 2018

Hematologist Nurse Phone number Dr. R. Foley Karen Running, RN 905-389-4411, ext. 42074 Dr. G. Fraser Tracy Allan, RN 905-387-9495 Dr. B. Leber Tracey Mullen, RN 905-387-9495 Dr. K. Lepic Tracy Allan, RN 905-387-9495 Dr. T. Kouroukis Karen Running, RN 905-387-9495 Dr. D. Marcellus Shannon Hilton, RN 905-387-9495 Dr. H. Mian Wendy Bursey, RN 905-387-9495 Dr. M. Trus Wendy Bursey, RN 905-389-4411, ext. 42035 Dr. I. Walker Barb Thorson, RN 905-387-9495 Dr. P. Wasi Shannon Hilton, RN 905-387-9495 Tracey Mullen, RN Dr. C. Hillis Shannon Hilton, RN 905-387-9495 Other health care providers Nurse Practitioners Clinical Trial Nurses Stem Cell Transplant Coordinators Allo Transplant Coordinators Name, phone/extension Notes PD 5887 01/2018 dpc/pted/hematologyteamjcc-insert-th.docx dt/january 9, 2018