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Adobe PDF Adobe PDF document  Health Assessment - Local Health Integration Network (LHIN)The file you are about to download will ONLY work properly if opened with an Adobe Reader 10 or later client. Please do not open this file in a browser.Fill, Print & Save1922.0 kb
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 Form Number:014-4768-69E-LHINEdition date: 2020/04 
 Title:Health Assessment - Local Health Integration Network (LHIN)
 Ministry:Health  
 Branch/ABC:Licensing and Policy  
 Program:Aging and Long-Term Care Unit  
 Purpose of Form:To be used for completion of the assessment required under the Long-Term Care Homes Act, 2007 when a person applies for a determination of eligibility for long-term care home admission. This form is for use effective the date when LHINs become designated as the placement co-ordinators for long-term care homes by the Ontario Ministry of Health and Long-Term Care.  

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