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Electronic Update Request - Service At Location Profile

If you require assistance in completing your change request, hover over the (question mark) and a short description of the field usage will display.



General Information

Service Name: Cardiac Rehabilitation

Location Information

* Building or Facility Name:
Room/Suite Number:
Building Number:
Street Name:
Street Type:
Quadrant:
City:
Province:
Postal Code:

Electronic Communication: Display Order (drag items to sort)

  •  Telephone: 780-735-7738

Hours of Operation

Is 24 Hour? Yes No
Hours of Operation:
Add/Edit Hours of Operation

Note:
Waiting Period:
Same as service: Yes No
Waiting Period?
Waiting Time:
Waiting Unit:
Note - Wait Period:

Service at Location Languages

Same as service: Yes No
Languages:
Note - Languages:

Accessibility

Wheelchair Accessible:
Note - Wheelchair Accessible:
Other Disabled Access:
Note - Other Disabled Access:
Transportation Description:

 

 

No Changes Required

 

Verification Contact Information

* Name:
Title:
One of Telephone or Email is required. A copy of submission will be sent to the email address if provided.
* Telephone:
*Email:
Comments:
*
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If this submission is successful, and you have provided your email address, you will receive an email confirmation.
If you do not receive this, please contact healthlink@albertahealthservices.ca