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Diabetes Center Referral Form Diabetes Self-management Training Phone (713) 4565150 Fax (713) 4565179 Please complete and fax: Name Home ...
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What is gestational diabetes referral form?
The gestational diabetes referral form is a form used to refer pregnant individuals who are at risk of or have been diagnosed with gestational diabetes to healthcare providers for further evaluation and management.
Who is required to file gestational diabetes referral form?
Healthcare providers, including obstetricians, midwives, and primary care physicians, are required to file the gestational diabetes referral form for their pregnant patients who are at risk of or have been diagnosed with gestational diabetes.
How to fill out gestational diabetes referral form?
Healthcare providers must fill out the gestational diabetes referral form by providing the patient's personal information, medical history, gestational diabetes risk factors, and any relevant test results.
What is the purpose of gestational diabetes referral form?
The purpose of the gestational diabetes referral form is to ensure that pregnant individuals at risk of or diagnosed with gestational diabetes receive timely and appropriate care and management.
What information must be reported on gestational diabetes referral form?
The gestational diabetes referral form must include the patient's personal information, medical history, gestational diabetes risk factors, and any relevant test results, as well as the healthcare provider's contact information.
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