AOC form - Shared Health

Please complete and submit the form below. Your entry will be added to the call log spreadsheet on the next regular working day.

Date of Call*

AOC Initials*

Type of Call*

Reason for Call*

Urgent (off hours)
In Hours
Not Urgent

Brief Description of Call*

Action Taken / Required*

Personal Health Information Act*

When submitting this information, I affirm that I will not disclose any personal or confidential information in accordance with the Personal Health Information Act. Additionally, I acknowledge that I am not authorized to share this account with anyone.

I agree
I disagree