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Page 1 of 2 Neonatal/Pediatric Referral Transport Checklist Patient Name Referral Date Referring Hospital Referring Doctor Referral Diagnosis DOB *Birth Time *Birth Weight *GA Present Weight Allergies
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How to fill out physicianstransportreferralchecklistdoc - ucsfbenioffchildrens
How to fill out physicianstransportreferralchecklistdoc - ucsfbenioffchildrens:
01
Start by opening the checklist document provided by UCSF Benioff Children's Hospital.
02
Begin filling out the necessary information in the designated sections, such as patient details, including name, date of birth, and contact information.
03
Proceed to complete the referring physician's information, including their name, contact information, and any relevant medical specialties.
04
Include the reason for the transport referral, detailing the medical condition or necessity for transportation.
05
Specify the mode of transportation requested, such as ground ambulance, helicopter, or air transport.
06
Provide any additional information or special considerations for the transportation team to be aware of, such as required medical equipment or medications.
07
If applicable, include any accompanying medical reports or documents that support the need for transportation.
08
Review the completed checklist for accuracy and completeness before submitting it to the appropriate department or transportation team.
Who needs physicianstransportreferralchecklistdoc - ucsfbenioffchildrens:
01
Parents or legal guardians of pediatric patients who require transportation to or from UCSF Benioff Children's Hospital.
02
Referring physicians or healthcare professionals who are seeking transportation services for their patients.
03
Transport coordinators or staff responsible for organizing and arranging medical transportation for patients.
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What is physicianstransportreferralchecklistdoc - ucsfbenioffchildrens?
The physicianstransportreferralchecklistdoc - ucsfbenioffchildrens is a document used for coordinating the transport of patients to UCSF Benioff Children's Hospital.
Who is required to file physicianstransportreferralchecklistdoc - ucsfbenioffchildrens?
Medical professionals, referring physicians, and transport coordinators are required to file the physicianstransportreferralchecklistdoc - ucsfbenioffchildrens.
How to fill out physicianstransportreferralchecklistdoc - ucsfbenioffchildrens?
The physicianstransportreferralchecklistdoc - ucsfbenioffchildrens must be filled out with patient information, medical history, necessary treatment details, and transport preferences.
What is the purpose of physicianstransportreferralchecklistdoc - ucsfbenioffchildrens?
The purpose of the physicianstransportreferralchecklistdoc - ucsfbenioffchildrens is to ensure safe and efficient transport of patients to UCSF Benioff Children's Hospital.
What information must be reported on physicianstransportreferralchecklistdoc - ucsfbenioffchildrens?
The physicianstransportreferralchecklistdoc must include patient demographics, medical conditions, medications, allergies, and contact information.
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