COVID-19 Hospital Transfer Form

COVID-19 Hospital Transfer Form


The COVID-19 Hospital Transfer Form is designed for family and other caregivers of adults with intellectual and developmental disabilities. In the event of a hospital admission for COVID-19, this form communicates essential information to hospital staff, including medical information, substitute decision-maker contacts and information about support needs. It promotes the accommodation of a person’s unique communication and behavioural support needs in health care. It is recommended to prepare this form in advance of a COVID-19 emergency and have it available upon a transfer to the hospital.

Download: Hospital Transfer Form Leave us your feedbackDownload: COVID-19 Formulaire de Transfert Hospitalier

How to prepare for a COVID-19 hospital visit

This tool is developed in response to the COVID-19 Pandemic by the Developmental Disabilities Primary Care Program of Surrey Place, Toronto, 2020. The content of this tool was subject to review by Surrey Place clinicians, primary care providers and other relevant stakeholders. Special acknowledgement of the invaluable contributions by Dr. Yona Lunsky, Director of the Azrieli Adult Neurodevelopmental Centre, and Senior Scientist at the Centre for Addiction and Mental Health, Toronto, and Dr. Ullanda Niel, family physician with special training in the care of adults with developmental disabilities from Queen’s University.