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Unit Record No. Surname F2241w Given Names REFERRAL TO MATER CHILDREN SPECIALIST CLINICS Date of Birth Sex AFFIX PATIENT IDENTIFICATION LABEL HERE To ensure a timely appointment, complete all sections
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How to fill out referral to mater childrens

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How to fill out a referral to Mater Children's:

01
Start by obtaining the referral form from your child's primary care physician or specialist.
02
Fill in your child's personal information, including their name, date of birth, and contact information.
03
Provide details about your child's medical condition or reason for the referral. Be as specific as possible to ensure the appropriate care is provided.
04
Include any relevant medical history or test results that may assist the Mater Children's staff in understanding your child's needs.
05
If your child has any allergies or medications, make sure to list them accurately on the form.
06
Fill out insurance information, including the policy number and any applicable authorizations or pre-certifications.
07
Review the completed form for accuracy and completeness before submitting it.
08
Submit the referral form to the Mater Children's hospital or clinic as instructed.

Who needs a referral to Mater Children's?

01
Children who have been referred by their primary care physicians for specialized medical care or treatment.
02
Children with complex medical conditions that require multi-disciplinary care and expertise offered by Mater Children's.
03
Children who may benefit from specialized diagnostic tests, surgeries, or interventions provided by Mater Children's.
04
Families seeking second opinions or specialized consultations for their children's medical conditions may require a referral to Mater Children's.
05
Some insurance plans may require a referral from primary care physicians before covering the costs of treatment or services at Mater Children's. Therefore, families whose children are covered under such plans may need a referral before accessing care at the facility.
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Referral to Mater Childrens is a process of recommending or directing a child to receive medical treatment or services at Mater Childrens Hospital.
Referral to Mater Childrens can be filed by healthcare professionals, such as doctors, nurses, or social workers, who believe a child may benefit from services at the hospital.
Referral to Mater Childrens can be filled out by providing the child's information, medical history, reason for referral, and any relevant supporting documents.
The purpose of referral to Mater Childrens is to ensure children receive appropriate medical care and services from specialists at the hospital.
Information such as the child's name, age, medical history, reason for referral, referring healthcare professional's details, and any supporting documents must be reported on the referral form.
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