Canada Form Ms 336 – Fill Out and Use This PDF

Canada Form Ms 336 PDF Details

Canada Form MS 336 is the official Maternity Pre-Admission Questionnaire for Mount Sinai Hospital in Toronto, Ontario. The form was last revised in January 2014. It gives the hospital what it needs to prepare your admission before your delivery date.

The questionnaire asks for information in four areas:

• Patient identification - your White Card Number, Ontario Health Card Number, marital status, and preferred language
• Delivery details - your expected due date, risk classification (high or low), and whether you expect multiples
• Emergency contact - name and phone number of your legal next of kin
• Room preference - ward, semi-private, or private room, depending on your insurance and availability

Non-Canadian residents are responsible for all hospital charges. The hospital recommends leaving valuables at home. On admission day, bring your health card, proof of supplementary insurance, and a credit card.

If you need a translator, mark the interpreter box on the form. Mount Sinai will arrange language services for your stay at no extra cost.