Yukon health care providers use this two-page form (YG 6572) to refer patients with chronic conditions to the Yukon Healthy Living Program. Services include chronic conditions nurse educators, clinical dietitians, cardiac and pulmonary rehabilitation, supervised exercise and home health monitoring. Staff assess client and service appropriateness at intake, and an exercise specialist screens anyone entering an exercise program.
The referring practitioner completes patient information, the primary reason for referral (such as COPD, asthma, diabetes, heart failure, CVD risk factors, arthritis or chronic pain), recent emergency visits or admissions, and the programs requested. A physician or nurse practitioner signs the standing order for spirometry and oxygen administration.
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Yukon Healthy Living Program (YHLP) referral form
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Health care providers use this form to refer patients, but every YHLP program and service also accepts self-referral. When a client requests access to clinical services, staff notify the primary care provider; no notice is sent when clients register for group education offerings.
Only the standing order section must be signed by a physician or nurse practitioner. It authorizes program clinicians (registered nurse, dietitian or clinical exercise specialist) to do diagnostic spirometry with bronchodilator testing and to give oxygen in acute situations, unless contraindicated.
Staff assess suitability and give appropriate clients a connected health kit, which may include a tablet, blood pressure cuff, scale and pulse oximeter, to record vital signs and answer symptom surveys. The program is voluntary, does not replace primary care and is not an emergency response system.