Get the free Ent gpwsi referral form Jan 2006 - icidsalisburynhsuk - icid salisbury nhs

Title: Microsoft Word ENT GPS referral form Jan 2006.doc Author: Gibson Created Date: 1/10/2006 12:07:01 PM

How to fill out ent gpwsi referral form

How to fill out an ENT GPWSI referral form:

1. Obtain the form: The ENT GPWSI referral form can typically be obtained from your primary care physician or the ENT department of your local hospital. It may also be available for download from the hospital's website.
2. Personal information: Start by entering your personal information on the form. This typically includes your full name, date of birth, contact details (phone number, address, email), and any relevant identification numbers like NHS number or patient reference number.
3. Referring healthcare professional: Indicate the name and contact details of the referring healthcare professional, such as your GP or another specialist who is referring you to the ENT GPWSI services.
4. Reason for referral: Clearly state the reason for your referral to the ENT GPWSI. Include any specific symptoms or concerns that you have, as well as any relevant medical history or previous investigations done.
5. General medical history: Fill in any general medical history that might be relevant to your ENT condition. This may include allergies, past surgeries, chronic illnesses, or medications you are currently taking.
6. Investigations and test results: If you have had any relevant investigations or tests done before the referral, make sure to provide the details and attach copies of the results whenever possible. This may include imaging scans, audiology reports, or previous ENT specialist opinions.
7. Relevant medications: List any medications you are currently taking, including prescribed medications, over-the-counter drugs, or herbal supplements. It is important to disclose this information as it may have an impact on your ENT condition or the treatment you may receive.
8. Patient consent: Read and sign the patient consent section, acknowledging your understanding and agreement to the referral process and any necessary sharing of medical information between healthcare providers involved in your care.

Who needs ENT GPWSI referral form?

Patients who are experiencing ear, nose, or throat symptoms or conditions that require specialist evaluation and treatment may need an ENT GPWSI referral form. These individuals typically include:

1. Patients with chronic or recurring ear infections
2. Individuals with hearing loss, tinnitus, or balance problems
3. Those suffering from sinus problems or chronic sinusitis
4. Patients with tonsillitis or persistent sore throat issues
5. Individuals with voice or swallowing difficulties
6. Patients with suspected head and neck cancers
7. Individuals with nasal deformities or nasal congestion
8. Those experiencing allergies affecting the ears, nose, and throat.

It is important to remember that specific criteria may vary based on local healthcare guidelines and individual assessment by the referring healthcare professional.

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What is ent gpwsi referral form?

The ENT GPWSI referral form is a form used to refer a patient to the Ear, Nose, and Throat (ENT) specialist with a special interest (GPWSI) in a particular area of expertise.

Who is required to file ent gpwsi referral form?

Any healthcare professional such as a general practitioner or a specialist who wishes to refer a patient to an ENT GPWSI must fill out the referral form.

How to fill out ent gpwsi referral form?

The form can typically be filled out online or on paper, and it should include the patient's information, the reason for the referral, relevant medical history, and any other relevant details.

What is the purpose of ent gpwsi referral form?

The purpose of the form is to provide necessary information for an ENT GPWSI to assess the patient's condition and provide appropriate treatment or further care.

What information must be reported on ent gpwsi referral form?

The form must include the patient's personal details, medical history, reason for referral, any relevant test results, and any other information that may be helpful for the specialist.