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Dr. Barbara Sector The Breast Center REFERRAL FORM (PLEASE PRINT) 71231 109 Street Edmonton AB T6G 1B9 Date: Oct 30, 2012 Phone: 7804372060 Fax: 7804372067 Patients Name: Mickey Mouse Address: 1234
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What is the breast centre referral?
The breast centre referral is a document that refers a patient to a specialized centre for breast health care.
Who is required to file the breast centre referral?
Medical professionals such as doctors or breast health specialists are required to file the breast centre referral.
How to fill out the breast centre referral?
The breast centre referral can be filled out by providing the patient's information, reason for referral, and any relevant medical history.
What is the purpose of the breast centre referral?
The purpose of the breast centre referral is to ensure that patients receive specialized care for breast health concerns.
What information must be reported on the breast centre referral?
The breast centre referral must include the patient's demographics, reason for referral, relevant medical history, and any tests or imaging results.
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