Required fields are marked with asterisks (*)

As of Monday, October 17, 2022,  Residents living in Long-Term Care may designate an unlimited number of “Caregiver” visitors. 

Caregivers provide direct care and support to a resident (e.g., supporting assistance with meals, mobility, personal hygiene, cognitive stimulation, emotional support etc). Caregiver visits do not need to be scheduled.

A caregiver visitor is defined as:

  • Someone that is 16 years of age or older
  • designated in writing by the resident or substitute decision maker (SDM)
  • Visiting to provide direct care to the resident (e.g. assisting with a meal, personal hygiene, emotional support etc.)
  • Is willing to follow all of the require infection control requirements while visiting (as outlined on the caregiver declaration form)

Caregivers must:

  • Be willing to provide direct care (e.g. assisting with a meal, personal hygiene, emotional support etc.)
  • Answer screening questions and undergo a Rapid Test for COVID-19 before entering the Home
  • Complete mandatory training on personal protective equipment
  • Commit to following the infection control guidelines and requirements
I am a:
 

We are required by the Ministry of Long-Term Care to provide education to each Caregiver Visitor on the proper use of Personal Protective Equipment before their first visit. Our preferred method of meeting this requirement is to email links to videos to watch on your computer or smart phone before you visit Sunnyside.  If applicable, please provide an email address for both Caregivers.  If a Caregiver does not have access to a computer, we will contact you to make alternate arrangements for the training before the first visit. 

To avoid delays, please review the email address carefully to ensure that it is entered correctly.  

Important things to note about Caregiver Visits:

    • Visiting restrictions are currently in place, please visit regionofwaterloo.ca/sunnysidehome for the most up to date information
    • Please allow for two full business days for this form to be processed (this does not include the day on which the form was submitted).
    • After submitting this form, the Caregiver will recieve the information listed in this section along with the links to the educational videos.  The education must be completed before the Caregiver's first visit.
    • If you have any questions about this form or about visits to Sunnyside Home, please call 519 893 8494 extension 6868.