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Four Counties Health Services - Diagnostic Imaging Services
Service Name:
Name 1:   
Name 2:   
Name 3:   
Former Name:   
Contact Details: Main Phone:   
Toll-Free:   
TTY:   
Crisis:   
After Hours:   
Fax:   
Email:   
Website:   



Mailing Information: c/o:         Street Address: (if different)
Building:   
Address:   
City:   
Province:   
Postal Code:   
Room:
Intersection:
Accessibility:
Accessibility Notes:
Hours:
Type of hours:
Other type label:
Day of Week
Opens:
Closes:
 
Type Holiday Day of Week Opens Closes
Service Sun 12noon 4pm [X]
Service Mon 7:30am 6pm [X]
Service Tue 7:30am 6pm [X]
Service Wed 7:30am 6pm [X]
Service Thu 7:30am 6pm [X]
Service Fri 7:30am 6pm [X]
Service Sat 10am 6pm [X]
Other Sun 12noon 3pm [X]
Other Mon 8am 5pm [X]
Other Tue 8am 5pm [X]
Other Wed 8am 5pm [X]
Other Thu 8am 5pm [X]
Other Fri 8am 5pm [X]
Other Sat 12noon 3pm [X]
Hours Notes:
 
Dates Available:



Executive: Name:   
Title:   
Organization:   
Phone:   
Email:   
Executive 2: Name:   
Title:   
Organization:   
Phone:   
Email:   



Public Contact: Name:   
Title:   
Organization:   
Phone:   
Email:   
Public Contact 2: Name:   
Title:   
Organization:   
Phone:   
Email:   
Service Description:
Meetings:






Funding:
Fees:
Application:
Eligibility / Target Population
Languages:



French
Language Note:
Area Served:
Year Established:
Legal Status:



Downloads:   
PDF documents to be included with a service profile can be emailed to esc.engagement@hccontario.ca (max. 500 kB in size)



YouTube Video #1 URL:   
Title:   
YouTube Video #2 URL:   
Title:   
YouTube Video #3 URL:   
Title:   



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Source Contact: Name:   
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Organization:   
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Comments:



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