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FAX completed forms to 6042333198 or email to rmdfallsprevention@vch.ca (Password Protected)Richmond Public Health Richmond Fall Prevention Program ReferralDATE OF REFERRAL: ___ (dd / mm / by)PATIENT

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How to fill out fall prevention form submitted

01

Gather all relevant information regarding the person at risk of falling.

02

Start by entering the person's personal information such as name, age, and contact details.

03

Provide details about the person's medical history, current medications, and any existing conditions that may increase the risk of falling.

04

Include information about the person's mobility status, balance, and ability to perform daily activities independently.

05

Document any previous falls or near misses, as well as any interventions or strategies currently in place to prevent falls.

06

Review and verify all the information provided before submitting the form.

Who needs fall prevention form submitted?

01

Any individual who is at risk of falling due to age, medical conditions, medications, or other factors should have a fall prevention form submitted for their safety.

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What is fall prevention form submitted?

The fall prevention form submitted is a document designed to identify and prevent fall hazards at a specific location or site.

Who is required to file fall prevention form submitted?

Any organization or individual responsible for the safety of workers at a site where fall hazards exist is required to file the fall prevention form.

How to fill out fall prevention form submitted?

The fall prevention form should be completed by assessing the site for fall hazards, implementing measures to prevent falls, and documenting these efforts on the form.

What is the purpose of fall prevention form submitted?

The purpose of the fall prevention form is to ensure that appropriate measures are in place to prevent falls and protect the safety of workers at a site.

What information must be reported on fall prevention form submitted?

The fall prevention form should include details of identified fall hazards, preventive measures taken, and any incidents or near misses related to falls.

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