Get the free Specialty Referral Form for Hawai‘i’s CSHCN

This document is used for referring patients with special health care needs to specialty medical services in Hawai‘i.

How to fill out specialty referral form for

How to fill out Specialty Referral Form for Hawai‘i’s CSHCN

1. Obtain the Specialty Referral Form from the Hawai‘i CSHCN website or your healthcare provider.
2. Complete the patient's information section, including name, date of birth, and contact details.
3. Fill out the referring provider's information section with your details.
4. Indicate the specialty needed by checking the appropriate box or writing it down.
5. Provide a detailed description of the reason for the referral, outlining the patient's condition and any relevant history.
6. Attach any necessary medical records or documentation that support the referral.
7. Review the form for completeness and accuracy to ensure all required fields are filled out.
8. Submit the completed form to the specified specialist or the relevant healthcare facility.

Who needs Specialty Referral Form for Hawai‘i’s CSHCN?

1. Children with Special Health Care Needs (CSHCN) in Hawai‘i who require specialized medical services.
2. Parents or guardians seeking specialist care for their child.
3. Healthcare providers who need to refer their patients to specialists for further evaluation or treatment.

For pdfFiller’s FAQs

What is Specialty Referral Form for Hawai‘i’s CSHCN?

The Specialty Referral Form for Hawai‘i’s CSHCN (Children with Special Health Care Needs) is a document used to refer patients to specialized medical services that cater to their specific health care needs.

Who is required to file Specialty Referral Form for Hawai‘i’s CSHCN?

Health care providers who are referring a child with special health care needs to a specialist are required to file the Specialty Referral Form for Hawai‘i’s CSHCN.

How to fill out Specialty Referral Form for Hawai‘i’s CSHCN?

To fill out the Specialty Referral Form for Hawai‘i’s CSHCN, healthcare providers should provide patient information, details of the referral, including the reason for referral and necessary medical history, ensuring all sections are completed accurately.

What is the purpose of Specialty Referral Form for Hawai‘i’s CSHCN?

The purpose of the Specialty Referral Form for Hawai‘i’s CSHCN is to streamline the referral process for children with special health care needs, ensuring they receive the appropriate specialized care in a timely manner.

What information must be reported on Specialty Referral Form for Hawai‘i’s CSHCN?

The information that must be reported on the Specialty Referral Form for Hawai‘i’s CSHCN includes patient details (name, date of birth, insurance information), the referring provider's information, the specialist's information, the reason for the referral, and relevant medical history.