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GREAT NECK PUBLIC SCHOOLS Health Services Scoliosis Referral Date Name Grade Teacher Dear Parent: Your child was screened for scoliosis (curvature of the spine). The screenings indicate the need for

How to fill out scoliosis referral

How to fill out a scoliosis referral:

1. Start by obtaining the appropriate referral form from your healthcare provider or the scoliosis clinic. This form may vary depending on the specific healthcare facility or organization.
2. Fill out your personal information accurately on the referral form. This typically includes your full name, date of birth, contact information, and insurance details. Make sure to double-check the information for any errors.
3. Provide a brief explanation of your symptoms or concerns related to scoliosis. It is important to be specific and include any relevant medical history that may be contributing to your condition.
4. If you have undergone any previous tests or diagnostic procedures related to your scoliosis, provide details of these exams on the referral form. This could include X-rays, CT scans, or MRI reports.
5. Indicate the name and contact information of the healthcare provider who will be receiving the referral. Make sure to include their name, clinic or hospital address, and contact number. It is helpful to check with your healthcare provider beforehand if you are unsure of this information.
6. Sign and date the referral form, as some facilities may require your authorization to release your medical records.
7. Keep a copy of the referral form for your records before submitting it to the appropriate healthcare provider or the scoliosis clinic.

Who needs a scoliosis referral?

1. Individuals who are experiencing symptoms associated with scoliosis, such as back pain, uneven shoulder or hip levels, or noticeable spine curvature, may require a scoliosis referral. These symptoms are typically evaluated by a healthcare professional who may recommend further examination or treatment options.
2. People with certain risk factors for scoliosis, such as a family history of the condition or certain medical conditions such as Marfan syndrome or cerebral palsy, may also need a scoliosis referral. These risk factors may increase the likelihood of developing scoliosis and necessitate closer monitoring or specialized care.
3. Healthcare providers, such as primary care physicians or pediatricians, who suspect that a patient may have scoliosis based on physical examination findings or patient complaints, may initiate a scoliosis referral. This referral facilitates a more in-depth evaluation by a specialist who can provide an accurate diagnosis and appropriate treatment plan.

For pdfFiller’s FAQs

What is scoliosis referral?

A scoliosis referral is a recommendation or request for further evaluation and treatment of scoliosis, a condition characterized by an abnormal sideways curvature of the spine.

Who is required to file scoliosis referral?

Healthcare professionals such as doctors, physical therapists, or chiropractors are typically responsible for filing scoliosis referrals.

How to fill out scoliosis referral?

To fill out a scoliosis referral, healthcare professionals need to provide relevant patient information, details of the scoliosis diagnosis, and recommendations for treatment or further evaluation.

What is the purpose of scoliosis referral?

The purpose of a scoliosis referral is to ensure that patients with scoliosis receive appropriate care, including monitoring of the condition and access to treatment options.

What information must be reported on scoliosis referral?

Key information to include on a scoliosis referral may consist of patient demographics, results of diagnostic tests, details of the scoliosis diagnosis, and recommended treatment plan.

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