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WORKING IN PARTNERSHIP TO ASSIST INDIVIDUALS AND FAMILIES WITH RECOVERY FROM CHEMICAL DEPENDENCY

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Calder Centre

2003 Arlington Avenue

Saskatoon, SK Canada S7J 2H6 Tel: (306) 655-4500 Fax: (306) 655-4545

Addictions Counsellor provides the following

(http://www.saskatoonhealthregion.ca)

ADULT ADMISSION INFORMATION GUIDE

Community Addictions Counsellor and/or other community professional may submit a referral request for a client

Saskatchewan residents, who have a current HSN, are eligible for service

Requests for admission should contain a Provincial Mental Health and Addictions Primary Assessment form. (This can be found on the Calder website)

For clients from the Saskatoon Health Region, please submit an internal referral through AMIS as well as submit the requested documentation. Please provide us with the client’s AMIS #

Client provides the following

PERSONAL INFORMATION SHEET (To be completed by applicant) DATE: ______________________________ SURNAME: _______________ GIVEN NAMES: ___________________ DOB: ________ AGE: ______ MARITAL STATUS: S M WD D CL TREATY NUMBER: _________________ BAND NAME: ________________________________________________ EDUCATION: ___________________________________ OCCUPATION: ___________________________________ ARE YOU RECEIVING SOCIAL SERVICE BENEFITS: Y/N EMPLOYEE ASSISTANCE REFERRAL: Y/N WORKER’S NAME: _______________________________________ PHONE NUMBER: ______________________ LEGAL ISSUES: Y/N PROBATION/PAROLE WORKER: _________________________ NUMBER: ______________

TELL US ABOUT YOURSELF

HAVE YOU BEEN IN TREATMENT BEFORE? (WHEN/WHERE/HOW LONG?)

________________________________________________________________________________________________________ ________________________________________________________________________________________________________ WHAT WAYS IS YOUR SUBSTANCE USE A PROBLEM FOR YOU? ______________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ WHAT ARE YOUR COMMUNITY SUPPORT SYSTEMS? (AA/NA/ACOA/GA/SPONSOR/CHURCH ETC) ____________ ______________________________________________________________________________________________________ ________________________________________________________________________________________________________ WHAT ARE YOUR NEEDS AND EXPECTATIONS OF THE PROGRAM? IDENTIFY SPECIFIC GOALS:

________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ANY PAST OR CURRENT LEGAL HISTORY? (CHARGES/DATES) _______________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ TELL US ABOUT YOUR HEALTH: (MEDICAL CONDITIONS/ALLERGIES/MEDICATION)

________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ MENTAL HEALTH HISTORY: (CONDITIONS/MEDICATION/PSYCHIATRIST)

________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________

PLEASE RETURN COMPLETED FORM TO YOUR COMMUNITY CASE MANAGER ATTACH ADDITIONAL PAPER AS REQUIRED

‘WORKING IN PARTNERSHIP TO ASSIST INDIVIDUALS AND FAMILIES WITH RECOVERY FROM CHEMICAL DEPENDENCY”

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Calder Centre Patient Information Sheet

Arrangements have been made for you to attend Calder Centre, an inpatient treatment centre for adolescents, adults, and their families who need more specialized help than is readily available in their home community.

Spending Money: Adult Program:

Your personal spending money is your responsibility. On average, $40 a week will cover recreational, personal hygiene supplies, coffee money, and gas or bus fare to meetings or social outings. If you are on social assistance, your CCM and local Social Services office will assist you in making arrangements to have your cheque re-routed for the duration of your stay.

Transportation:

Admission/discharge transportation is your responsibility. This includes cab fare to and from the bus depot or airport. About $12 –15.00 one way.

Time of Arrival:

Your CCM will inform you of your admission date and time. It is important that you arrive for that time. If you run into unforeseen delays, please call us at 655-4500 and let our receptionist know what time you expect to arrive.

What to Bring:

Plan for Calder Centre to be your “home” for the time you are here. Rooms are usually double occupancy. Do feel free to bring comfortable things to make your room “yours” such as your pillow, comforter and photographs. Parking is available should you wish to bring your car. Calder Centre is a "scent-free" environment; please refrain from bringing cologne, perfume, air freshener, scented candles, etc.

This is a general list of things you will need during your stay: - Your personal health card

- A four-week supply of prescription medication you may be on, over the counter medications are discouraged

- Casual, comfortable clothing

- Seasonal clothing as required for out of doors activities - Running shoes

- Alarm clock/radio - Swimsuit and towel - Toiletries

- Musical instruments if you play and hobby/crafts you enjoy - Books, if you enjoy reading

- A covered mug (travel mug) to use while you are here.

- Calder endorses a strict “scent free” environment.

** Please refrain from bringing any electronics, such as cell phones, laptops, I-Pads, I-pods, Playbooks, etc. These items are prohibited in Calder Centre’s program. They must be handed in at admission and will be returned at transfer.

** Clients can have and use personal music devices while in the program ie. MP3, Ipods, so long as they do not have camera capabilities.

All meals, laundry facilities, bedding and towels are provided.

ADULT: Please bring $5.00 to cover the cost of a covered mug (if you do not have one) Visitors:

Family members can call you or visit during your stay. Staff will help you arrange for day visits, and for if your guests stay for meals with you. It is your decision to have visitors, or receive phone calls. You will be asked to give written permission to let callers and visitors know you are here. The client list is always

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PHYSICAL

EXAMINATION Name: PHN: DOB:

Return to: Return to: Calder Centre 2003 Arlington Avenue Saskatoon, SK S7J 2H6 Tel: (306) 655-4500 Fax: (306) 655-4545 Vital Signs: BP____________ HR_______________ Resp___________ Ht_____________ Wt_____________ Temp__________

Normal Abnormal Not

Assessed Specify Abnormalities

Skin Head

Eyes – General Eyes –

Fundoscopy Ear & Nose Mouth Neck Cardiovascular Respiratory* (Thorax) Abdomen Lymph nodes Extremities CNS – Gait Level of Consciousness Cranial Nerves Neuro – Reflexes Motor & Sensory Breast/Genital/Rectal

Medications (include OTC drugs) ____________________________________________________________________ ____________________________________________________________________________________________________ Allergy (describe reaction) __________________________________________________________________________ ____________________________________________________________________________________________________ Past Medical History ________________________________________________________________________________ ____________________________________________________________________________________________________

Social History – Current Occupation __________________________ Smoking ___ Alcohol _______

Routine Pre-Admission Lab Work CBC

Lytes/BUN/CR Diagnosis and Proposed Management

F.B.S. (spot okay) ___________________________________________ Liver Function Test ___________________________________________

HBSAG/B/C ___________________________________________

Routine Urinalysis ___________________________________________ Forward Results to:

Calder Centre Physician’s Signature __________________________________ 2003 Arlington Ave.

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Mental Health & Addiction Services

Calder Centre

2003 Arlington Avenue

Saskatoon, SK S7J 2H6

Tel: 306.655-4500

Fax: 306.655-4545

January 9, 2008

Attention: Community Case Managers

It has come to our attention that there may be misinformation in the community about the

Saskatoon Health Region smoking policy implementation at Calder Centre and the impact

upon clients when participating in our program. We want to take this opportunity to ensure

that all referral sources provincially have accurate information to pass along to clients, which

will assist them in making an informed decision about entering residential treatment.

Upon admission to Calder, clients are given information regarding Nicotine Replacement

Therapy, and given the opportunity to quit smoking should they choose to do so. Although

smoking in and around Calder Centre property is prohibited, provisions have been made for

clients to leave the property and smoke in designated areas off-site. This applies to all adult

clients, even client where clinical presentation requires them to have restricted community

access for a duration of time.

Should you or your client have further questions regarding the smoking policy or any other

questions regarding our program, please contact myself or Calder Centre main office. We’ll be

happy to provide you with any information we can. Additionally, you can find information for

yourself and clients on the website at

www.saskatoonhealthregion.ca

, just follow the links and

find Calder Centre information under Programs & Services\Mental Health & Addiction

Services\Adult Services\Residential Treatment – Adult (Calder Centre)\Adult Admission Guide

PDF.

Sincerely,

Nicole Schumacher

Adult Program manager

Mental Health & Addiction Services

Calder Centre

(P) 655-4523 (F) 655-4545

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Mental Health & Addiction Services Calder Centre 2003 Arlington Avenue Saskatoon, SK S7J 2H6 Tel: 306.655-4500 Fax: 306.655-4545

August 1, 2011

Attention: Provincial Addictions Counselors

Subject: Cell phone use at Calder Centre

For those of you whom make referrals to Calder Centre, we wanted to communicate a change

to our Adult Program expectations. As of August 15, 2011, adult clients will no longer be

allowed to have cell phones while in our program. They must be handed in to staff at admission

and placed in a secure room, with any other belongings that are restricted, ie perfume,

camera’s, laptops, and returned to the client at transfer.

We have found that having access to cell phones proves to be a distraction for clients, taking

focus away from the program. Also, due to most phones having camera and video camera

capabilities, they significantly impact the ability we have as staff to ensure confidentiality for

our clients. Our moving to not allowing cell phones is consistent with other inpatient treatment

centres throughout the province.

To ensure that clients continue to have a means to access family, friends and other supports,

we’ve added to the client phones (land lines) that clients can use while in the program.

I am requesting your help with communicating this information around cell phones to your

client’s prior to referral and admission, and encourage client’s to come to Calder with long

distance calling cards, etc should they need them.

Also prohibited while at Calder Centre are laptops, I-pads, Blackberry Playbooks, IPOD touch,

camera’s, etc. Clients may bring with them personal music devices ie. MP3’s, Discman, Ipod, so

long as they do not have camera capabilities.

Thank you in advance for your cooperation with this program change.

Should you have further questions regarding this change or require any additional information

about the Calder Centre programs, please access information on our website at

www.saskatoonhealthregion.ca

, or call Calder at 655-4500.

Sincerely

Nicole Schumacher

Adult Program Manager

Mental Health & Addiction Services

Calder Centre

Saskatoon Health Region

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CALDER CENTRE - ADULT PROGRAM EXPECTATIONS

One to Client - One to your File

We are looking forward to you coming to Calder Centre. By entering our program you have indicated your choice to lead a recovery-oriented lifestyle. To help you achieve this goal we ask that you respect the following

expectations during your stay:

Abstain from the use of all mood-altering substances. Any medications that clients bring to Calder must be prescribed by a physician including over the counter & herbal medications. All prescription, over the counter and herbal medications must be turned into Calder Centre staff. Usage of

unauthorized substances may result in transfer to a Detox facility or your home community.

Smoking or use of any tobacco products is not permitted in Calder Centre, or on surrounding

property. Clients found in violation of this Health Region policy may be transferred; however, individuals found to be smoking in the building will be subject to immediate discharge. Consider an active role, or initiation of a smoking cessation program (if applicable), Nicotine Replacement Therapy (NRT), Nicorettes, Nicotine inhaler, or supported abstinence. Program components will be offered to support this initiative.

You will be required to be on Calder Centre property during all non-programming times until urine screen results indicate you are free from all substances of abuse.

Supervised Admission and Random Urine Drug screens will be conducted throughout your stay.

At admission, staff will conduct personal, luggage and, if applicable, vehicle searches. Staff may conduct random searches of your room/belongings throughout your stay.

Cell phones, laptops, I-Pads, I-pods, camera’s, etc are not allowed in the Calder Centre program.

Avoid establishments whose primary purpose is the sale of alcoholic beverages, for example bars,

lounges, and liquor stores; situations or persons where alcohol drug use, is likely to occur.

Refrain from all forms of gambling.

Attend and participate in all scheduled Calder Centre programming, unless otherwise negotiated

Respect yourself, others, and Calder property. Refrain from aggressive or intimidating behavior toward Calder Centre clients or staff. This includes fighting, threats - verbal, physical or otherwise,

abusive/offensive language and obscene gestures.

Social contact with residents of the Calder Centre Youth Program is not permitted.

All residents are to be in the Centre prior to scheduled lights out. Leaving the building following lights

out may result in transfer.

Calder staff will call you a few days before your scheduled admission date. You consent for them to call you at a phone number provided to them.

Prospective clients must have all matters pertaining to medical insurance, disability, or related income claim forms completed and managed by a physician in the community prior to attendance at the centre

I, ____________________________________________(Print Name) have reviewed the Calder Centre expectations with my community addiction’s counselor and agree to follow these expectations to the best of my ability. By signing this document I am confirming my attendance on the date reflected on the admission notification fax.

Client Signature ____________________________________Date_______________________ Phone #’s Home: __________________ Cell: __________________ Other: __________________

www.saskatoonhealthregion.ca

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