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Request for Support application

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1264

Health Authority: Interior

Division: Central Okanagan Division of Family Practice

Published Date: 2019-02-22

Link to File: http://divisionsbc.ca/sites/default/files/Divisions/Central%20Okanagan/Request%20for%20Support.pdf

Description: "This is a form to request for support application"

Health Authority: Interior

Division: Central Okanagan Division of Family Practice

Corporate Author: Central Okanagan Division of Family Practice

Published Date: 2019-02-22

Resource Type: Form

File Type: Pdf

Link to File: http://divisionsbc.ca/sites/default/files/Divisions/Central%20Okanagan/Request%20for%20Support.pdf

Originating web page: http://www.divisionsbc.ca/central-okanagan/your-division/request-for-support

Description: This is a form to request for support application

Preventive Care Checklist for New Immigrants and Refugees

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1277

Health Authority: Island

Division: Cowichan Valley Division of Family Practice

Published Date: 2019-03-20

Link to File: http://www.ccirhken.ca/ccirh/checklist_website/en/pdf/central_middle_east.pdf

Description: "Evidence-Based Preventive Care Checklist for New Immigrants and Refugees, Central Middle East region."

Health Authority: Island

Division: Cowichan Valley Division of Family Practice

Corporate Author: University of Ottawa

Published Date: 2019-03-20

Resource Type: Checklist

File Type: Pdf

Link to File: http://www.ccirhken.ca/ccirh/checklist_website/en/pdf/central_middle_east.pdf

Originating web page: http://www.divisionsbc.ca/cowichan-valley/resources/links-resources

Description: Evidence-Based Preventive Care Checklist for New Immigrants and Refugees, Central Middle East region.

Colonoscopy Screening Referral form

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1283

Health Authority: Island

Division: Nanaimo Division of Family Practice

Published Date: 2019-02

Link to File: http://www.divisionsbc.ca/sites/default/files/Divisions/Nanaimo/referral%20form%20Hep%20C.pdf

Description: "Colonoscopy Screening Referral form"

Health Authority: Island

Division: Nanaimo Division of Family Practice

Corporate Author: Nanaimo Division of Family Practice

Published Date: 2019-02

Resource Type: Form

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/Divisions/Nanaimo/referral%20form%20Hep%20C.pdf

Originating web page: http://www.divisionsbc.ca/nanaimo/resources/clinical-resources

Description: Colonoscopy Screening Referral form

Colonoscopy screening criteria for asymptomatic patients

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1284

Health Authority: Island

Division: Nanaimo Division of Family Practice

Published Date: 2019-02

Link to File: http://www.divisionsbc.ca/sites/default/files/Divisions/Nanaimo/Screening%20Colonoscopy%20Direct%20referral%20form%202013.pdf

Description: "This is the Colonoscopy screening criteria for asymptomatic patients form"

Health Authority: Island

Division: Nanaimo Division of Family Practice

Corporate Author: Nanaimo Division of Family Practice; Vancouver Island Health Authority

Published Date: 2019-02

Resource Type: Form

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/Divisions/Nanaimo/Screening%20Colonoscopy%20Direct%20referral%20form%202013.pdf

Originating web page: http://www.divisionsbc.ca/nanaimo/resources/clinical-resources

Description: This is the Colonoscopy screening criteria for asymptomatic patients form

Looking for a Family Doctor in North shore

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1299

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Program: A GP for Me

Published Date: 2019

Link to File: https://surveys.divisionsbc.ca/Survey.aspx?s=68e29ca0598547fd89e8ca15e37e0f5a

Description: "an online form to help find a doctor in North Shore"

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Program: A GP for Me

Corporate Author: North Shore Division of Family Practice

Published Date: 2019

Resource Type: Form

File Type: Web page

Link to File: https://surveys.divisionsbc.ca/Survey.aspx?s=68e29ca0598547fd89e8ca15e37e0f5a

Originating web page: http://www.divisionsbc.ca/north-shore/our-initiatives/patient-focused/find-a-doctor

Description: an online form to help find a doctor in North Shore

Activity Record - Board of Directors

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1303

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Published Date: 2019

Link to File: http://www.divisionsbc.ca/sites/default/files/traeburn/Activity%20Record.BoD_.2018.02.01.v1.pdf

Description: "This is the Board of directors activty record form"

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Corporate Author: North Shore Division of Family Practice

Published Date: 2019

Resource Type: Form

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/traeburn/Activity%20Record.BoD_.2018.02.01.v1.pdf

Originating web page: http://www.divisionsbc.ca/north-shore/resources/forms

Description: This is the Board of directors activty record form

Activity Record - Division Members

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1304

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Published Date: 2019

Link to File: http://www.divisionsbc.ca/sites/default/files/traeburn/22.%20Activity%20Record.General.2018.01.19.pdf

Description: "This is the division members activity record form"

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Corporate Author: North Shore Division of Family Practice

Published Date: 2019

Resource Type: Form

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/traeburn/22.%20Activity%20Record.General.2018.01.19.pdf

Originating web page: http://www.divisionsbc.ca/north-shore/resources/forms

Description: This is the division members activity record form

Billing and Tax Information Form

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1305

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Published Date: 2019

Link to File: http://divisionsbc.ca/sites/default/files/Divisions/North%20Shore/Billing%20and%20Tax%20Information%20Form.2017.v2.pdf

Description: "This is the billing and tax information form"

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Corporate Author: North Shore Division of Family Practice

Published Date: 2019

Resource Type: Form

File Type: Pdf

Link to File: http://divisionsbc.ca/sites/default/files/Divisions/North%20Shore/Billing%20and%20Tax%20Information%20Form.2017.v2.pdf

Originating web page: http://www.divisionsbc.ca/north-shore/resources/forms

Description: This is the billing and tax information form

Direct Deposit Agreement Form

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1306

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Published Date: 2019

Link to File: http://www.divisionsbc.ca/sites/default/files/traeburn/Direct%20Deposit%20Agreement%20Form.2017.v2.pdf

Description: "This is the direct deposit agreement form"

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Corporate Author: North Shore Division of Family Practice

Published Date: 2019

Topics: Billing

Resource Type: Form

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/traeburn/Direct%20Deposit%20Agreement%20Form.2017.v2.pdf

Originating web page: http://www.divisionsbc.ca/north-shore/resources/forms

Description: This is the direct deposit agreement form

Meeting Attendance Record

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1307

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Published Date: 2019

Link to File: http://www.divisionsbc.ca/sites/default/files/traeburn/Meeting%20Attendance%20Record.General.2018.01.19.pdf

Description: "This is the meeting attendance record form"

Health Authority: Vancouver Coastal

Division: North Shore Division of Family Practice

Corporate Author: North Shore Division of Family Practice

Published Date: 2019

Resource Type: Form

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/traeburn/Meeting%20Attendance%20Record.General.2018.01.19.pdf

Originating web page: http://www.divisionsbc.ca/north-shore/resources/forms

Description: This is the meeting attendance record form

Physician Sessional Form

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1308

Health Authority: Vancouver Coastal

Division: Richmond Division of Family Practice

Published Date: 2018-04

Link to File: http://www.divisionsbc.ca/sites/default/files/sajwang/FILLABLE%20-Physician%20Reimbursement%20Form%20-%20Apr%202018.pdf

Description: "This is the physician sessional form"

Health Authority: Vancouver Coastal

Division: Richmond Division of Family Practice

Corporate Author: Richmond Division of Family Practice

Published Date: 2018-04

Topics: Billing

Resource Type: Form

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/sajwang/FILLABLE%20-Physician%20Reimbursement%20Form%20-%20Apr%202018.pdf

Originating web page: http://www.divisionsbc.ca/richmond/your-division/sessional-forms

Description: This is the physician sessional form

MOA Sessional Form

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1309

Health Authority: Vancouver Coastal

Division: Richmond Division of Family Practice

Published Date: 2018

Link to File: http://www.divisionsbc.ca/sites/default/files/sajwang/MOA%20Reimbursement%20Form.pdf

Description: "This is the MOA Sessional form"

Health Authority: Vancouver Coastal

Division: Richmond Division of Family Practice

Corporate Author: Richmond Division of Family Practice

Published Date: 2018

Topics: Billing

Resource Type: Form

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/sajwang/MOA%20Reimbursement%20Form.pdf

Originating web page: http://www.divisionsbc.ca/richmond/your-division/sessional-forms

Description: This is the MOA Sessional form

New Patient Registration Form

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1310

Health Authority: Vancouver Coastal

Division: Sea to Sky Division of Family Practice

Program: A GP for Me

Published Date: 2019

Link to File: http://www.divisionsbc.ca/sites/default/files/Divisions/Sea%20to%20Sky/Patient%20Intake%20Form.pdf

Description: "This is the new patient registration form"

Health Authority: Vancouver Coastal

Division: Sea to Sky Division of Family Practice

Program: A GP for Me

Corporate Author: Sea to Sky Division of Family Practice

Published Date: 2019

Resource Type: Form

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/Divisions/Sea%20to%20Sky/Patient%20Intake%20Form.pdf

Originating web page: http://www.divisionsbc.ca/sea-sky/for-residents/gp-directory

Description: This is the new patient registration form

Getting prepared for your appointment with your family doctor

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1313

Health Authority: Vancouver Coastal

Division: Vancouver Division of Family Practice

Program: A GP for Me

Published Date: 2019

Link to File: http://www.divisionsbc.ca/sites/default/files/inline-files/Checklist_be%20prepared%20for%20your%20appointment_0.pdf

Description: "how to be prepared for your appointment with your family doctor "

Health Authority: Vancouver Coastal

Division: Vancouver Division of Family Practice

Program: A GP for Me

Corporate Author: Vancouver Division of Family Practice

Published Date: 2019

Resource Type: Checklist

File Type: Pdf

Link to File: http://www.divisionsbc.ca/sites/default/files/inline-files/Checklist_be%20prepared%20for%20your%20appointment_0.pdf

Originating web page: http://www.divisionsbc.ca/vancouver/patients

Description: how to be prepared for your appointment with your family doctor

Assessing Evaluation Question Checklist

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1341

Published Date: 2004

Link to File: https://www.cdc.gov/asthma/program_eval/assessingevaluationquestionchecklist.pdf

Description: "This is a checklist to help focus your evaluation"

Corporate Author: Centre for Disease Control and Prevention

Published Date: 2004

Topics: Evaluation

Resource Type: Checklist

File Type: Pdf

Link to File: https://www.cdc.gov/asthma/program_eval/assessingevaluationquestionchecklist.pdf

Originating web page: http://divisionsbc.ca/provincial/resources/assessment-measurement/developing-evaluation-planframework

Description: This is a checklist to help focus your evaluation

Thinking in Networks and Managing Change Initiative - Information Sheet & Application

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1483

Program: Divisions of Family Practice

Published Date: 2019-08-22

Link to File: /media/divresources/THINCInfoSheet_&_Request_for_Services.docx

Description: "The initiative provides the opportunity for Divisions and their CSC partners to engage the services of Ron Lindstrom & Adam King to understand, evaluate and improve the quality and strength of relationships toward successful PCNs and other ongoing collaborative work. This document provides information on the initiative, and also has the steps to take to request services from both consultants."

Program: Divisions of Family Practice

Corporate Author: General Practice Services Committee; JSC/RCCbc

Published Date: 2019-08-22

Topics: Primary Care; Primary Care Network; Patient Medical Home; Funding; Governance; Finances

Resource Type: Information Package; Template; Form

File Type: Word

Link to File: /media/divresources/THINCInfoSheet_&_Request_for_Services.docx

Description: The initiative provides the opportunity for Divisions and their CSC partners to engage the services of Ron Lindstrom & Adam King to understand, evaluate and improve the quality and strength of relationships toward successful PCNs and other ongoing collaborative work. This document provides information on the initiative, and also has the steps to take to request services from both consultants.

Minor Tenant Improvement (MTI) Funding Submission Form

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource1550

Published Date: 2019-08

Link to File: /media/divresources/TEMPLATE-Minor-Tenant-Improvement-Funding-Submission-Form.docx

Description: "This template is to be used by Divisions when applying for MTI funding."

Corporate Author: General Practice Services Committee

Published Date: 2019-08

Topics: Patient Medical Home; Primary Care Network; Funding

Resource Type: Form

File Type: Word

Link to File: /media/divresources/TEMPLATE-Minor-Tenant-Improvement-Funding-Submission-Form.docx

Description: This template is to be used by Divisions when applying for MTI funding.

Board Skills / Experience Matrix

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource407

Program: Divisions of Family Practice

Link to File: /media/divresources/2015MayDivisionBoardMatrix.doc

Description: "Example matrix of board skills and experience which can be filled in."

Program: Divisions of Family Practice

Corporate Author: Vantage Point

Topics: Board of Directors

Resource Type: Form

File Type: Word

Link to File: /media/divresources/2015MayDivisionBoardMatrix.doc

Description: Example matrix of board skills and experience which can be filled in.

Succession Management Transitions - Contingency Inventory Template

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource410

Program: Divisions of Family Practice

Link to File: /media/divresources/ContingencyInventoryFinal.pdf

Description: "The contingency inventory includes recommendations for including information in the following areas: 1. Not-For-Profit/Charity Status & Critical Info 2. Policy Information 3. Financial Information 4. Contracts & Fund Development/Grants 5. Human Resources 6. Insurance 7. Facilities Management 8. Legal Information 9. Document Security & Passwords"

Program: Divisions of Family Practice

Corporate Author: Vantage Point

Topics: Insurance; Succession Planning

Resource Type: Template; Form

File Type: Pdf

Link to File: /media/divresources/ContingencyInventoryFinal.pdf

Description: The contingency inventory includes recommendations for including information in the following areas: 1. Not-For-Profit/Charity Status & Critical Info 2. Policy Information 3. Financial Information 4. Contracts & Fund Development/Grants 5. Human Resources 6. Insurance 7. Facilities Management 8. Legal Information 9. Document Security & Passwords

Hope Partners in Health Care Community Forum Evaluation Questions

https://www.jcc-resourcecatalogue.ca/en/permalink/divisionresource415

Health Authority: Fraser

Division: Chilliwack Division of Family Practice

Program: A GP for Me

Published Date: 2014-02-24

Link to File: /media/divresources/HopeHealthPromoCommunityForumEvaluation.pdf

Description: "A one-page event evaluation survey."

Health Authority: Fraser

Division: Chilliwack Division of Family Practice

Program: A GP for Me

Corporate Author: Chilliwack Division of Family Practice

Published Date: 2014-02-24

Topics: Evaluation; Health Promotion

Event: Hope Health Promo Community Forum

Resource Type: Form; Survey

File Type: Pdf

Link to File: /media/divresources/HopeHealthPromoCommunityForumEvaluation.pdf

Description: A one-page event evaluation survey.

29 public records – page 1 of 2.