Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with CISSS des Laurentides – Hôpital de Saint-Jérôme before sending sensitive documents. FaxFlow is not affiliated with this organization.
CISSS des Laurentides – Hôpital de Saint-Jérôme fax number
(450) 431-8314
Hôpital de Saint-Jérôme
Used for: Referral to the Regional TCCL program for mild traumatic brain injury; fax the Grille de repérage TCCL (G-3047) and accompanying clinical documentation to the external number.
Fax destination details
- Department
- Hôpital de Saint-Jérôme
- Purpose
- Referral to the Regional TCCL program for mild traumatic brain injury; fax the Grille de repérage TCCL (G-3047) and accompanying clinical documentation to the external number.
- Form
- G-3047 Grille de repérage Traumatisme Crânio-Cérébral Léger (TCCL) – Laurentides — Grille de repérage TCCL Léger (G-3047)
- Address
- 290, rue de Montigny, Saint-Jérôme, QC J7Z 5T3
- Voice phone
- 450-432-2777
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill out the Grille de repérage TCCL; if the diagnostic criteria are met, refer the client to the Regional TCCL program in the Laurentides. Fax the form and clinical documents to 450-431-8314.
Official form instructions are published as a downloadable file on the organization's website.
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