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PHYSIATRIST CONSULTATION SCHOOL REFERRAL FORM Please return to: I. Macomb Intermediate School District Assessment Center 44001 Garfield Rd. Clinton Township MI 480381100 IDENTIFYING INFORMATION A.

How to fill out physiatric consultation school pre-referral

To fill out a physiatric consultation school pre-referral form, follow these steps:

1. Start by gathering all the necessary information about the student in question. This includes their personal details, medical history, and any relevant documentation, such as previous assessments or Individualized Education Plans (IEPs).
2. Begin the pre-referral form by providing the student's basic information, such as their full name, age, grade level, and school identification number. Make sure to double-check the accuracy of this information before moving forward.
3. Next, document the reason for the referral. Specify why the student is being referred for a physiatric consultation. This could be due to concerns about their physical well-being, performance, or any specific issues they may be experiencing.
4. Provide a detailed description of the student's current physical condition or limitations, if applicable. Highlight any medical diagnoses or conditions that may be relevant to the referral, such as mobility issues, chronic pain, or developmental delays.
5. Include any information about the student's previous medical interventions or therapies, if applicable. This can help the physiatrist understand the student's previous experiences and provide tailored recommendations and interventions.
6. If the student has undergone any recent medical assessments or evaluations, attach copies of these reports to the pre-referral form. This will provide the physiatrist with additional information and enable them to make a more accurate assessment.
7. Clearly state the specific goals or expectations for the physiatric consultation in relation to the student's academic performance or participation in school activities. Outline what outcomes are desired from the consultation and how it can support the student's overall development and well-being.
8. Once the form is completed, make sure to review it for any errors or missing information. Double-check the spelling of names and the accuracy of contact information before submitting it for further processing.

Who needs physiatric consultation school pre-referral?

1. Students who are experiencing physical limitations or conditions that may impact their ability to fully participate in school activities.
2. Students who require additional support or interventions related to their physical well-being, such as therapy or adaptive equipment.
3. Students who have undergone recent medical assessments or evaluations that indicate the need for specialized physical intervention or consultation.
4. Students who have a history of physical health concerns that may require ongoing monitoring or intervention in an educational setting.
5. Students who require assistance in developing strategies or accommodations to meet their individual physical needs and facilitate their academic success.

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What is physiatric consultation school pre-referral?

Physiatric consultation school pre-referral is a process where a student's need for physical and rehabilitation medicine services in a school setting is assessed before the official referral is made.

Who is required to file physiatric consultation school pre-referral?

Typically, a school administrator or allied health professional is responsible for initiating and filing the physiatric consultation school pre-referral.

How to fill out physiatric consultation school pre-referral?

To fill out physiatric consultation school pre-referral, the individual will need to provide detailed information about the student's condition, challenges, and the services needed.

What is the purpose of physiatric consultation school pre-referral?

The purpose of physiatric consultation school pre-referral is to assess the student's need for physical and rehabilitation medicine services in a school setting to help them succeed academically.

What information must be reported on physiatric consultation school pre-referral?

The physiatric consultation school pre-referral should include information about the student's medical history, current challenges, recommendations for services, and any other relevant information.