This form is designed to communicate vital information about a patient with IDD in the event of a hospital stay and can be completed by the person with IDD, their family or support person, or both. This form can provide hospital staff with key medical information, substitute decision-makers contacts, and information about support needs of the person. Such information promotes the accommodations needed for a person’s unique communication and behavioral support needs in a health care setting. It is recommended that this form be prepared in advance of an emergency and have it available upon admission to the hospital.
After you download and save the PDF file to your computer, it can (1) be printed and filled out by hand or (2) completed as a fillable PDF form on devices (e.g., laptop, iPad). See Using Fillable Forms in this Toolkit.
Read more about the My Hospital Form tool development.
Related Canadian Consensus Guidelines on the Primary Care of Adults with Intellectual and Developmental Disabilities