Toggle navigation Portfolio Hospital Site Details Exit and clear survey default Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters. Portfolio Hospital Site Details Dear Portfolio Hospitals, We are collecting details from each site to assist with matching to ACT research network clinical trials that are active or upcoming. Please answer the questions below to the best of your ability. If you have any questions about this survey, please contact aviva.blacher@phri.ca . Warm regards, ACT Networks Committee (This question is mandatory) 1. Please select your hospital name Choose one of the following answers Please choose... Cambridge Cardiac Care – Dr. Shekhar Pandey Cape Breton Regional Hospital (CBRH) – Dr. Paul McDonald Centre Hospitalier Régional de Lanaudière (CHRDL) – Dr. Simon Kouz Dr. Georges-L.-Dumont University Hospital Centre (DGLDUHC) – Dr. Rémi LeBlanc East Kootenay Regional Hospital (EKRH) – Dr. Denise Jaworsky Grace Hospital – Dr. Gloria Vazquez-Grande Health Sciences North (HSN) – Drs. Robert Ohle and Ravinder Jeet Singh Hôpital de la Cité-de-la-Santé – Dr. Stéphanie Castonguay Hôtel-Dieu de Lévis (HDL) – Drs. Patrick Archambault and Martin Crête Humber River Health (HRH) – Dr. Gihad Nesrallah Kelowna General Hospital (KGH) – Drs. Matthew Boyko and Aleksander Tkach Mackenzie Health – Drs. Kimia Honarmand and Tess Fitzpatrick Medicine Hat Regional Hospital (MHRH) – Dr. Alejandro Manosalva Nanaimo Regional General Hospital (NRGH) – Dr. David Forrest Niagara Health – Dr. Jennifer Tsang Penticton Regional Hospital (PRH) – Dr. Michelle Scheepers Qikiqtani General Hospital – Drs. Litvack and Sheffield Queen Elizabeth Hospital (QEH) – Dr. Heather Williams Regina General Hospital (RGH) – Dr. Payam Dehghani Windsor Regional Hospital (WRH) – Dr. Wassim Saad 2. At your site, please indicate all physicians and specialties (e.g., intensivist, respirologist, anesthesiologist) that are interested in collaborating on ACT trials. Name Specialty Email Collaborator 1 Name Specialty Email Collaborator 2 Name Specialty Email Collaborator 3 Name Specialty Email Collaborator 4 Name Specialty Email Collaborator 5 Name Specialty Email Collaborator 6 Name Specialty Email Collaborator 7 Name Specialty Email Collaborator 8 Name Specialty Email 3. What is the estimated size of your services? (answer as applicable) Number of inpatient beds Number of ICU beds Number of intermediate care unit (IMCU) beds Number of people in catchment area (This question is mandatory) 4. Which of the following services are available to trialists? Yes - on site Yes - off site Unsure Not available Intensive care unit Yes - on site Yes - off site Unsure Not available Stroke unit Yes - on site Yes - off site Unsure Not available Dialysis unit Yes - on site Yes - off site Unsure Not available Inpatient transplant unit Yes - on site Yes - off site Unsure Not available Medical day unit Yes - on site Yes - off site Unsure Not available Outpatient transplant care Yes - on site Yes - off site Unsure Not available Emergency room Yes - on site Yes - off site Unsure Not available Pediatric services Yes - on site Yes - off site Unsure Not available Interventional radiology services Yes - on site Yes - off site Unsure Not available Radiation oncology therapy Yes - on site Yes - off site Unsure Not available Administration of chemotherapy Yes - on site Yes - off site Unsure Not available Cardiac catheterization laboratory Yes - on site Yes - off site Unsure Not available Chronic Kidney Disease (CKD) clinic Yes - on site Yes - off site Unsure Not available Neurology clinic Yes - on site Yes - off site Unsure Not available Cardiology clinic Yes - on site Yes - off site Unsure Not available Blood processing facility Yes - on site Yes - off site Unsure Not available Level one trauma centre Yes - on site Yes - off site Unsure Not available 5. Are there any other features/services at your site that would be helpful for trialists to know? 6. (Optional) Supporting document with additional details Please upload at most one file Upload file Title Comment File name × Upload file Submit Please confirm you want to clear your response? Exit and clear survey ×