Application Form 1st PreferenceAdelaide Place, LindsayAllendale, MiltonAlmonte General HospitalBelmont LTC Facility (Belleville)Bruyere OttawaCampbellford Memorial HospitalCambridge Memorial HospitalCanterbury GardensCare Partners- Bruce-GreyCaressant Care (Mary St)Caressant Care MarmoraCarleton Place and District HospitalCBI Home HealthChartwell Ballycliffe LTCChartwell Waterford LTCChartwell Wynfield LTCCobourg Retirement ResidenceCommunity Care City of Kawartha LakesEmpress GardensExtendicare BramptonExtendicare CobourgExtendicare Kawartha LakesExtendicare LakefieldExtendicare OshawaExtendicare Port HopeExtendicare Scarborough (Lawrence Ave)FairhavenGlen Hill Strathaven (Bowmanville)Golden PloughGroves Memorial HospitalHaliburton Highlands Health ServicesHalton HealthcareHillsdale TerraceHospice PeterboroughHospice QuinteHumber River HospitalKawartha Heights Retirement LivingKawartha Participation Projects (KPP)Kingston Health Sciences (KHSC)Lakeridge Health (Bowmanville, Oshawa, Port Perry, Whitby)Lakeridge Health (Ajax-Pickering, non-clinical)Leacock Care CenterLegion Village IncLennox and Addington County General HospitalLondon Health SciencesManitoulin Centennial ManorManitoulin Health CentreManitoulin LodgeMapleview Retirement Residence (Norwood)Niagara HealthNorthumberland Hills HospitalOntario ShoresOrillia Soldiers' Memorial HospitalOttawa-Carleton Detention CentreParamed Durham/Kawartha LakesPeterborough Public HealthPeterborough Retirement ResidencePRHCPrincess GardensQueensway Carleton HospitalQuinte HealthcareRevera Living - Fenelon Court LTCRiverview ManorRoss Memorial HospitalRoyal GardensRubidge Retirement ResidenceSchlegel Villages - The Village of Erin MeadowsSchlegel Villages - The Village of Humber HeightsSeasons Retirement CommunitiesSE HealthSienna Senior LivingSilver Lights Senior ServicesSt Joseph's at FlemingSt. Joseph's General Hospital (Elliot Lake)Stewart HomesSunnybrookThe Peterborough ClinicTrillium Health PartnersVictoria ManorVON HastingsVON Peterborough NorthumberlandNorth Wellington Health CareWoodstock HospitalCity Other 2nd PreferenceAdelaide Place, LindsayAllendale, MiltonAlmonte General HospitalBelmont LTC Facility (Belleville)Bruyere OttawaCampbellford Memorial HospitalCambridge Memorial HospitalCanterbury GardensCare Partners- Bruce-GreyCaressant Care (Mary St)Caressant Care MarmoraCarleton Place and District HospitalCBI Home HealthChartwell Ballycliffe LTCChartwell Waterford LTCChartwell Wynfield LTCCobourg Retirement ResidenceCommunity Care City of Kawartha LakesEmpress GardensExtendicare BramptonExtendicare CobourgExtendicare Kawartha LakesExtendicare LakefieldExtendicare OshawaExtendicare Port HopeExtendicare Scarborough (Lawrence Ave)FairhavenGlen Hill Strathaven (Bowmanville)Golden PloughGroves Memorial HospitalHaliburton Highlands Health ServicesHalton HealthcareHillsdale TerraceHospice PeterboroughHospice QuinteHumber River HospitalKawartha Heights Retirement LivingKawartha Participation Projects (KPP)Kingston Health Sciences (KHSC)Lakeridge Health (Bowmanville, Oshawa, Port Perry, Whitby)Lakeridge Health (Ajax-Pickering, non-clinical)Leacock Care CenterLegion Village IncLennox and Addington County General HospitalLondon Health SciencesManitoulin Centennial ManorManitoulin Health CentreManitoulin LodgeMapleview Retirement Residence (Norwood)Niagara HealthNorthumberland Hills HospitalOntario ShoresOrillia Soldiers' Memorial HospitalOttawa-Carleton Detention CentreParamed Durham/Kawartha LakesPeterborough Public HealthPeterborough Retirement ResidencePRHCPrincess GardensQueensway Carleton HospitalQuinte HealthcareRevera Living - Fenelon Court LTCRiverview ManorRoss Memorial HospitalRoyal GardensRubidge Retirement ResidenceSchlegel Villages - The Village of Erin MeadowsSchlegel Villages - The Village of Humber HeightsSeasons Retirement CommunitiesSE HealthSienna Senior LivingSilver Lights Senior ServicesSt Joseph's at FlemingSt. Joseph's General Hospital (Elliot Lake)Stewart HomesSunnybrookThe Peterborough ClinicTrillium Health PartnersVictoria ManorVON HastingsVON Peterborough NorthumberlandNorth Wellington Health CareWoodstock HospitalCity Other 3rd PreferenceAdelaide Place, LindsayAllendale, MiltonAlmonte General HospitalBelmont LTC Facility (Belleville)Bruyere OttawaCampbellford Memorial HospitalCambridge Memorial HospitalCanterbury GardensCare Partners- Bruce-GreyCaressant Care (Mary St)Caressant Care MarmoraCarleton Place and District HospitalCBI Home HealthChartwell Ballycliffe LTCChartwell Waterford LTCChartwell Wynfield LTCCobourg Retirement ResidenceCommunity Care City of Kawartha LakesEmpress GardensExtendicare BramptonExtendicare CobourgExtendicare Kawartha LakesExtendicare LakefieldExtendicare OshawaExtendicare Port HopeExtendicare Scarborough (Lawrence Ave)FairhavenGlen Hill Strathaven (Bowmanville)Golden PloughGroves Memorial HospitalHaliburton Highlands Health ServicesHalton HealthcareHillsdale TerraceHospice PeterboroughHospice QuinteHumber River HospitalKawartha Heights Retirement LivingKawartha Participation Projects (KPP)Kingston Health Sciences (KHSC)Lakeridge Health (Bowmanville, Oshawa, Port Perry, Whitby)Lakeridge Health (Ajax-Pickering, non-clinical)Leacock Care CenterLegion Village IncLennox and Addington County General HospitalLondon Health SciencesManitoulin Centennial ManorManitoulin Health CentreManitoulin LodgeMapleview Retirement Residence (Norwood)Niagara HealthNorthumberland Hills HospitalOntario ShoresOrillia Soldiers' Memorial HospitalOttawa-Carleton Detention CentreParamed Durham/Kawartha LakesPeterborough Public HealthPeterborough Retirement ResidencePRHCPrincess GardensQueensway Carleton HospitalQuinte HealthcareRevera Living - Fenelon Court LTCRiverview ManorRoss Memorial HospitalRoyal GardensRubidge Retirement ResidenceSchlegel Villages - The Village of Erin MeadowsSchlegel Villages - The Village of Humber HeightsSeasons Retirement CommunitiesSE HealthSienna Senior LivingSilver Lights Senior ServicesSt Joseph's at FlemingSt. Joseph's General Hospital (Elliot Lake)Stewart HomesSunnybrookThe Peterborough ClinicTrillium Health PartnersVictoria ManorVON HastingsVON Peterborough NorthumberlandNorth Wellington Health CareWoodstock HospitalCity Other Is there any other information you feel would be helpful for the Placement Liason to know? (Examples includes childcare concerns, housing, etc.):Is there a conflict of interest with any of your placement site requests? If yes, please explain as you cannot be placed at that site: Only fill in if you are not human