My Hospital Form

The Hospital Form is designed for family or other support persons of adults with intellectual and developmental disabilities to communicate essential information in the event of a hospital admission. 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.

Download: My Hospital Form

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 tool development and meet the team at the bottom of this web page.

Related Canadian Consensus Guidelines on the Primary Care of Adults with Intellectual and Developmental Disabilities

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