Juravinski E2: Please fill out this form if you have spent more than 6 hours on the E2 unit at the Juravinski Hospital from January 7th onward. EHS will follow up as required: https://forms.gle/5XfdnJNygiK6CqJW7
Juravinski E4: Please fill out the following form if you have spent more than 6 hours on Ward E4 at the Juravinski Hospital between January 13th – 20th : https://forms.gle/N4D7kA63ubckubRR7
Juravinski Patient Contact Tracing – E4 Room 2: Please fill out this form if you were in contact with a patient in Room 2, Ward E4 between January 18th 1645 hrs and January 19th 0100 hrs https://forms.gle/Hygu6oG39UXb18zHA
Juravisnki E2 PPE Survey: EHS is determining if contact tracing is required and will only follow up if they determine contact tracing is necessary. Please fill out the following form if you’ve been on E2 at the Juravinski Site January 16th 0700 hrs to January 21st 0600 hrs only. https://forms.gle/yqdkpfx37sQX5bnj8
Juravinski E4 PPE Survey: EHS is determining if contact tracing is required and will only follow up if they determine contact tracing is necessary. Please fill out the following form if you’ve been on E4 at the Juravinski Site January 19th 0030 hrs to January 21st 0030 hrs only. https://forms.gle/xLXJbDAeTKVq6voR6
Juravisnki Hospital – F5 Point Prevalence: Please fill out this form if you’ve been on F5 between January 18th – present day https://forms.gle/N4VHPDJ1GJ7FrSP16
St Joseph’s Healthcare Hamilton- Charlton Site, Mary Grace Unit
Please provide the following information if you have been present at St. Joseph’s Healthcare Hamilton , Charlton Site, 5 Mary Grace Unit, between January 13th – January 20th . Your information will be provided to Occupational Health Services for follow up.
https://docs.google.com/forms/d/e/1FAIpQLSexyKfTqt073vS3uCKAscE-sjKrnoNlnP9g8uQDLYuYJONHfA/viewform?vc=0&c=0&w=1&flr=0
St Joseph’s Healthcare Hamilton- Charlton Site, 6GI
Please provide the following information if you have been present at St. Joseph’s Healthcare Hamilton , Charlton Site, 6GI Unit, between January 12th – January 20th . Your information will be provided to Occupational Health Services for follow up.
https://docs.google.com/forms/d/e/1FAIpQLSctEWqqsvGIXvHxAWjaa1lZce14X0df3OevjVoIGvgaeMrBFw/viewform?vc=0&c=0&w=1&flr=0
McMaster Children’s Hospital: Please fill out the following form if you had exposure to a patient at McMaster Children’s Hospital on Ward 3C, Bed 21-B between January 11th – 20th (Note: Patient was also in MRI on January 17th): https://forms.gle/ChPZt84zs5rDuYjr5
DATES AMENDED MUMC 3C: Please note dates changed for criteria – Please only fill out this form if you had contact with a patient in Bed 21-B, Ward 3C between January 15th – 20th (previously listed as January 11th) https://forms.gle/7xLZ9xcAQ7VKGayc7
MUMC Contact Tracing: Please complete this form if you had contact with a patient on 4C Room 12 and/or B1 in NICU between January 28th – 29th https://forms.gle/WuSCoFY1HTXA6cgg6
McMaster University Medical Centre/McMaster Children’s Hospital – 3Y1 Patient Contact: Please fill out this form if you were in contact with a patient on 3Y1 Room 21-B between January 24th 1858 hrs and January 25th 1345 hrs https://forms.gle/8t9dpLo4fMEkUXxX7
Hamilton General Hospital: Please fill out the following form if you have spent more than 6 hours in the Emergency Department at the Hamilton General Hospital between January 6th – 20th (Note: this includes time spent in the ED Consult Room): https://forms.gle/yh77Eq57MHBQ9XJc8
Hamilton General – Zoster Exposure B2N: Please fill out this form if you were exposed to a patient in Room 113 on B2N at the HGH between January 17th 0001 hrs – Jan 21 1300 hrs for possible exposure to Disseminated Shingles (Varicella Zoster): https://forms.gle/1v6bMTxbgsBnmngq6
Hamilton General – COVID Exposure 8 West: Please fill out this form if you were exposed to a patient in Room 8 Bed 1 on 8 West at the HGH between January 17th – 23rd: https://forms.gle/9EJVJbjK25jDERbVA
Hamilton General – COVID Exposure 4 West/CCU: Please fill out this form if you were exposed to a patient who spent time on 4 West in 16-1 and/or CCU 10 at the HGH site. 4 West between January 21 0800 hrs – January 23 1955 hrs and CCU between January 23 1955 hrs and January 24 0830 hrs: https://forms.gle/hpUGpop8bbqC2KQ39
Hamilton General Hospital – 5 West Point Prevalence: Please fill out this form if you’ve been on 5 West between January 18th – present day https://forms.gle/66KDuVFhbEBvwkey9
Hamilton General Hospital – 5 South Patient Contact: Please fill out this form if you were in contact with a patient on 5 South room 6 between January 22nd 2140 hrs – 29th 1246 hrs https://forms.gle/yp6UT1oQfE3NAR1u6
West Lincoln Memorial Hospital: Please fill out the following form if you have spent time on Ward C at the West Lincoln Memorial Hospital between January 11th – 20th : https://forms.gle/MxiEdHd3DyKGE5KC9
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