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APPLICATION PROCESS

 

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  • Referrals can be made by the individual, family member, other professional, physician, lawyer etc.
  • All applicants must complete the “Application for Service Form” prior to being considered or accepted into any of BISNO’s services. Incomplete applications will be returned to the applicant / referring agent. Please note that we require the Application for Service form be signed by the applicant or the substitute decision maker. Indicate specific rehabilitation goals and need(s) on the form.
  • Whenever possible, provide relevant collateral information or at minimum, details as to where this information can be obtained.
  • The Intake Coordinator is responsible to conduct an initial screening of all applicants, gather relevant collateral information and to present a profile of the applicant to the Admissions Committee.
  • The Admissions Committee reviews the application and makes a recommendation regarding approval for service.
  • Applicants approved for service are notified by the Chief Executive Officer, as the chair of the Admissions Committee.

An applicant may be declined services if he/she does not meet the eligibility criteria. Applicants who have not been approved are notified by the Chair of the Admissions Committee and are provided with details regarding the appeal process.

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Click here to download Application for Service - English

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Click here to download Application for Service - French

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Click here to download Physician's Referral Form

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Click here to download Education & Consultion Request

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Click here to download Bill of Rights

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Click here to download Consent to Communicate

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Click here to download Consent for Mailing Lists

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Click here to download Consent to Disclose - Compiled by BISNO

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Click here to download Consent to Disclose - Compiled by External Provider

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Click here to download Privacy Code 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT US


Email: bisnoro@bisno.org
Main: 807-623-1188
Toll-Free: 1-866-796-1188


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Brain Injury Association of Thunder Bay

Download Application for Service
Accreditation
Supported by:
Supported by Northwest Local Health Integration Network
THIS FUNDING IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE
MULTI-SECTOR SERVICE ACCOUNTABILITY AGREEMENT (M-SAA).
TO VIEW, PLEASE CLICK HERE M-SAA .