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PublicHealthNurseReferralForm FaxReferralsto: PublicHealthNursing A en on:IntakeUnit Phone:(925)3136924 Fax:(925)3136029 Referralwillbereviewedandreferred toPHNifappropriate. Ethnicity: DateofReferral:

How to fill out public health nurse referral

How to fill out a public health nurse referral:

1. Start by obtaining the necessary referral form from your healthcare provider or local public health department. The form may also be available online.
2. Carefully read the instructions provided on the referral form. Make sure you understand the purpose and requirements of the referral.
3. Begin filling out the referral form by providing your personal information, such as your name, contact information, and date of birth.
4. Next, provide relevant healthcare details, such as your current medical condition, any known allergies, and any medications you are currently taking. This information will help the public health nurse understand your specific needs.
5. Specify the reason for the referral. It could be related to a specific health concern, a need for ongoing healthcare management, or a recommendation from your healthcare provider.
6. If you have a preferred public health nurse or clinic location, indicate it on the referral form. Otherwise, leave it blank, and the public health department will assign you a nurse based on availability and proximity.
7. In case you have any specific requests or additional information that could be useful for the public health nurse, include it in the designated section of the form.
8. Review the completed referral form carefully to ensure all the information provided is accurate and up-to-date.
9. Once you are confident that the referral form is complete and accurate, submit it to the appropriate entity, which may be your healthcare provider or directly to the local public health department. Follow any specific submission instructions provided on the form.
10. Keep a copy of the filled-out referral form for your records, as it may be helpful to have the information on hand during future healthcare appointments.

Who needs a public health nurse referral:

1. Individuals who require specialized medical care or management related to their specific health condition may need a public health nurse referral. This can include individuals with chronic illnesses, disabilities, or complex medical needs.
2. Individuals who have been referred by their healthcare provider for follow-up care, education, or support provided by public health nurses may need a referral.
3. Individuals who are unable to access or afford private healthcare services may benefit from a public health nurse referral. Public health nurses often provide essential healthcare services to underserved populations.
4. New parents or families with young children may require a public health nurse referral for assistance with newborn care, breastfeeding support, or child development assessments.
5. Some public health departments may have specific eligibility criteria for accessing their services. Individuals who meet these criteria may need a referral to access public health nurse services.
6. Those seeking health education, promotion, or preventive services offered by public health nurses may require a referral to access these resources.

Remember, the specific requirements for a public health nurse referral may vary depending on your location and the services provided by your local public health department. It is always advisable to consult with your healthcare provider or contact your local public health department for accurate and detailed information on how to fill out a public health nurse referral.

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What is public health nurse referral?

Public health nurse referral is a process where individuals are referred to a public health nurse for assessment, education, and support regarding their health needs.

Who is required to file public health nurse referral?

Healthcare providers, social workers, schools, and other professionals may be required to file public health nurse referrals for individuals in need.

How to fill out public health nurse referral?

Public health nurse referrals can be filled out by providing the individual's basic information, reason for referral, and any relevant health history.

What is the purpose of public health nurse referral?

The purpose of public health nurse referral is to identify individuals who may benefit from the services and support provided by a public health nurse.

What information must be reported on public health nurse referral?

Information such as the individual's name, contact information, reason for referral, and any relevant health conditions should be reported on a public health nurse referral.