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Dysautonomia patient forms

Service updates for appointments at WCH

  • If you have an upcoming in person appointment at Women’s College Hospital and you have a fever, cough, or new onset of shortness of breath, tested positive for COVID-19, or been instructed to self-isolate by Public Health please do not come to the hospital, call the clinic directly for more information. If you have travelled outside of Canada in the past 14 days and are fully vaccinated and have not been advised to isolate, you are welcome to come to the hospital for your scheduled appointment.
  • The hospital is open only to patients with appointments, please see our care partner & visitor restrictions information.
  • Your appointment may be changed to a virtual visit using the telephone or over video. Learn how to set-up a video visit.
  • You will receive a call from us with any changes to your appointment.
  • Masks are required to be worn at all times on WCH property. This includes, but is not limited to, parking areas, elevators and while waiting to be screened.

Pelase download load and fill out the following forms, as directed by your healthcare team:

The Short Form Health Survey

Composite Autonomic Symptom Score

General Anxiety GAD-7 scale

 

 

 

 

Fully affiliated with

A member of

Council of Academic Hospitals of Ontario (CAHO)