Get the free Sending hospital order form revised May 2011 - nwmedstar

Patient Name Soc Sec# DOB Admit Date/Time ED Physician (Patient Label) PROTOCOL for ACUTE STROKE: 03 hours symptom onset (or 34.5 hours after review of additional exclusion criteria) Providence Spokane

How to fill out sending hospital order form

How to fill out a sending hospital order form:

1. Start by carefully reading the instructions on the form. Make sure you understand all the required fields and any specific guidelines provided.
2. Begin by filling out your personal information section. This usually includes your full name, contact details, and identification information such as your date of birth or social security number.
3. Next, provide information about the hospital you are sending the order to. This may include the hospital's name, address, and contact information.
4. In the relevant section, specify the purpose of the order. For example, if you are sending medical records or lab results, indicate that on the form.
5. If applicable, include any relevant medical information or details that the hospital may need to know. This could include your medical history, current medications, or any specific instructions related to your case.
6. Some order forms may require additional documentation or signatures. Make sure to review the entire form and provide any necessary attachments or signatures as instructed.
7. Double-check all the information you have provided to ensure accuracy and completeness. It is important to provide correct information for the hospital to process your request effectively.
8. Finally, submit the completed form to the appropriate department or individual as instructed by the hospital.

Who needs a sending hospital order form:

1. Patients who need to transfer their medical records from one hospital to another may need to complete a sending hospital order form. This allows the receiving hospital to request the necessary documents and information to provide seamless continuity of care.
2. Individuals who require special procedures or treatments at another hospital may also need to fill out a sending hospital order form. This ensures that the receiving hospital has all the relevant information needed to best meet the patient's healthcare needs.
3. Healthcare professionals, such as doctors or nurses, who are referring a patient to another hospital for a specific evaluation or specialized care may also be required to complete a sending hospital order form. This facilitates the transfer of key medical information and ensures appropriate coordination between healthcare providers.

In summary, filling out a sending hospital order form requires careful attention to detail and the provision of accurate and complete information. Patients needing to transfer medical records or receive specialized care at another hospital, as well as healthcare professionals referring patients, may need to complete such forms.

For pdfFiller’s FAQs

What is sending hospital order form?

Sending hospital order form is a document used to request the transfer of a patient from one hospital to another.

Who is required to file sending hospital order form?

The attending physician or hospital staff is typically required to file the sending hospital order form.

How to fill out sending hospital order form?

The sending hospital order form should be filled out with the patient's information, reason for transfer, and necessary medical details.

What is the purpose of sending hospital order form?

The purpose of sending hospital order form is to facilitate the transfer of a patient to another hospital while ensuring continuity of care.

What information must be reported on sending hospital order form?

The sending hospital order form must include patient's name, medical history, reason for transfer, current condition, and any special instructions.

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