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INTEGRATED FALLS SERVICE REFERRAL FORM Tel: 0208 714 2830 / 2850 / 2852 Fax: 020 8686 3330 Your referral will be streamlined by the Falls Coordinator to the most appropriate service. The service is
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How to fill out integrated falls service referral
How to fill out an integrated falls service referral:
01
Begin by obtaining the necessary referral form from the appropriate healthcare provider or organization. This form may be available in physical or digital format.
02
Fill out the patient information section on the referral form accurately. This includes the patient's full name, date of birth, contact information, and any relevant identification numbers (e.g., medical record number or healthcare card number).
03
Provide details about the healthcare professional or organization making the referral. Include their name, contact information, and identification numbers if applicable.
04
Clearly describe the reason for the referral in the designated section. Provide specific details regarding the patient's falls risk factors, history of falls, and any relevant medical conditions or medications.
05
Indicate the preferred falls prevention services or interventions that are being requested for the patient. This may include assessments, exercise programs, home safety evaluations, or educational resources.
06
If available, provide any supporting documentation or test results that may be relevant to the referral, such as recent medical reports or imaging studies. Ensure these documents are securely attached or digitally uploaded as per the referral process.
07
Sign and date the referral form in the designated area to confirm your agreement to refer the patient to the integrated falls service.
08
Submit the completed referral form to the appropriate falls service provider, following the specified submission method (e.g., fax, email, online portal). Retain a copy of the referral form and any supporting documents for your records.
Who needs integrated falls service referral:
01
Individuals who have a history of falls or are at risk of falling due to age-related factors, medical conditions, or medication use might require an integrated falls service referral.
02
Patients who are experiencing balance or mobility issues, have reduced muscle strength, or have experienced recent falls may benefit from an integrated falls service referral.
03
Older adults, particularly those over the age of 65, are often at a higher risk of falling and could benefit from an integrated falls service referral to receive appropriate assessments and interventions.
04
Individuals undergoing rehabilitation following an injury or surgery that has affected their balance or mobility may require an integrated falls service referral to aid in their recovery.
05
Healthcare professionals, such as physicians, physiotherapists, occupational therapists, or nurses, who identify concerns or risks related to falls in their patients can initiate an integrated falls service referral to ensure comprehensive care for their patients.
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What is integrated falls service referral?
Integrated Falls Service Referral is a process to refer individuals who are at risk of falling to appropriate services and resources to prevent falls.
Who is required to file integrated falls service referral?
Healthcare providers, social workers, or other professionals who identify individuals at risk of falling are required to file integrated falls service referral.
How to fill out integrated falls service referral?
Integrated Falls Service Referral can be filled out by providing detailed information about the individual at risk of falling, their medical history, current medications, and any existing support systems.
What is the purpose of integrated falls service referral?
The purpose of integrated falls service referral is to connect individuals at risk of falling with appropriate services and resources to prevent falls and improve their overall well-being.
What information must be reported on integrated falls service referral?
Information such as the individual's medical history, current medications, recent falls, mobility issues, and any existing support systems must be reported on integrated falls service referral.
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