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Psychiatry Referral Form 470-6137 (P) 470-6243 (Fax) NOT FOR MEDICAL RECORD Facility Name: Type of facility: Emergency Room Inpatient Outpatient Name/Title of caller: Phone: Fax Number: Date: Patient
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How to fill out durham regional hospital psychiatry
How to fill out Durham Regional Hospital Psychiatry:
01
Visit the front desk or reception area of the hospital and ask for a psychiatric evaluation form.
02
Fill out your personal information accurately, including your name, date of birth, address, and contact information.
03
Provide details about your medical history, including any previous psychiatric diagnoses, medications you are currently taking, and any allergies or sensitivities you may have.
04
Answer all questions on the form honestly and to the best of your knowledge. Be thorough and specific, providing as much information as possible to help the psychiatrist assess your needs.
05
If you are unsure about any questions or require assistance, do not hesitate to ask a staff member for help.
06
Once you have completed the form, return it to the front desk or designated drop-off area.
Who needs Durham Regional Hospital Psychiatry:
01
Individuals experiencing mental health issues such as depression, anxiety, bipolar disorder, schizophrenia, or other psychiatric conditions.
02
Those who require assessment and treatment for substance abuse or addiction disorders.
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Individuals who may be in crisis situations, experiencing suicidal thoughts or displaying self-destructive behaviors.
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People who have experienced traumatic events and are in need of counseling or psychological support.
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Those seeking assistance with managing stress, coping with life changes, or improving their overall mental well-being.
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Family members or caregivers who require guidance or support in dealing with a loved one's mental health issues.
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What is durham regional hospital psychiatry?
Durham Regional Hospital Psychiatry is a department within Durham Regional Hospital that specializes in providing psychiatric care to patients.
Who is required to file durham regional hospital psychiatry?
Durham Regional Hospital Psychiatry does not require individuals to file. Instead, it is the healthcare providers within the department who document and report patient information.
How to fill out durham regional hospital psychiatry?
Filling out Durham Regional Hospital Psychiatry forms involves documenting patient information, including their medical history, current symptoms, and any prescribed medications.
What is the purpose of durham regional hospital psychiatry?
The purpose of Durham Regional Hospital Psychiatry is to provide mental health treatment and care to patients who require psychiatric services, including evaluation, diagnosis, and therapy.
What information must be reported on durham regional hospital psychiatry?
Information that must be reported on Durham Regional Hospital Psychiatry forms includes patient demographics, medical history, current symptoms, diagnosis, treatment plan, and progress notes.
When is the deadline to file durham regional hospital psychiatry in 2023?
The deadline to file Durham Regional Hospital Psychiatry forms in 2023 is not specified. Please consult the hospital's guidelines or contact their administration for specific deadlines.
What is the penalty for the late filing of durham regional hospital psychiatry?
The penalty for the late filing of Durham Regional Hospital Psychiatry forms may vary depending on the hospital's policies. It is best to consult the hospital's guidelines or contact their administration for information regarding penalties.
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