Virtual Visit Request Form


Virtual Visit Request Form

To accommodate as many requests as possible, we are encouraging families and loved ones to coordinate times you can all connect together for a visit. The LHSC Virtual Visit Program offers the use of Webex, Skype or Facetime (*Facetime is only available for users with an Apple product). Each of these programs allow for multiple users / devices to log on simultaneously. We ask that you allow up to 3 business days for our team to get in touch with you about your visit. We will do our best to help you set up an virtual visit should you choose to fill out the below form.


Please also note that this program is not intended for those patients who already have access to their own devices to connect to family or loved ones, we kindly ask that you contact the unit staff if this is the case.


We are in the office from 8:00AM to 4:00PM Monday – Friday and are away on weekends.

(for Staff requests only)
Patient Information
(if known)
Identify the online program you are most comfortable using for your visit
Will additional assistance be needed to set up this technology for the patient?
For example, will your loved one require assistance holding the device steady, or learning to use the software for the call?
PLEASE NOTE: We are unable to disclose patient information without their full consent. This means you may not hear from our team until the patient in hospital has confirmed and approved connecting with you. We sincerely apologize for any delays this may cause in contacting your loved one. There may be circumstances where we are unfortunately unable to facilitate this contact.