Get the free SPECIALIST LYMPHOEDEMA SERVICE REFERRAL FORM South East - stchristophers org

SPECIALIST LYMPHEDEMA SERVICE REFERRAL FORM South East London Cancer Network ALL SECTIONS MUST BE COMPLETED PATIENT DETAILS REASONS FOR REFERRAL Surname First name Address Lymphedema secondary to

How to fill out specialist lymphoedema service referral

How to fill out specialist lymphoedema service referral:

1. Begin by obtaining the appropriate referral form from the specialist lymphoedema service provider. This form can usually be found on their website or by contacting their office.
2. Fill out the patient's personal information including their full name, date of birth, address, and contact details. This information is vital for proper identification and communication.
3. Provide the referring healthcare professional's information, such as their name, contact details, and any relevant identification numbers. This allows for effective coordination and communication between healthcare professionals.
4. Specify the reason for the referral in detail. Include the patient's medical history related to lymphoedema, any ongoing treatments or interventions, and the purpose of seeking specialist lymphoedema services. This helps the specialist service provider to understand the patient's specific needs.
5. Indicate any relevant test results, imaging reports, or diagnostic information that supports the referral. This can include lymphoscintigraphy results, Doppler ultrasound reports, or any other medical records that are available. These documents provide valuable insights for the specialist in assessing and developing an appropriate treatment plan.
6. If applicable, include any information regarding previous treatments or interventions for lymphoedema. This can include details of past therapies, surgeries, or medications used and their outcomes. This information assists the specialist in considering appropriate treatment options.
7. Ensure that the referral form is signed and dated by the referring healthcare professional. This confirms their endorsement and authorization of the referral.

Who needs specialist lymphoedema service referral:

1. Patients who have been diagnosed with lymphoedema or are suspected to have lymphoedema may require a specialist lymphoedema service referral. This referral allows them to access specialized care and interventions for managing their condition.
2. Individuals who have tried conservative treatments for lymphoedema such as compression garments, manual lymphatic drainage, or exercise without significant improvement may benefit from a specialist referral. The specialized expertise offered by a lymphoedema service provider can help explore alternative treatment options.
3. Patients with complex or severe cases of lymphoedema that require a multidisciplinary approach may also need a specialist lymphoedema service referral. This ensures proper coordination and integration of various healthcare professionals involved in the patient's care.

Remember to consult with the patient's primary healthcare provider or specialist before filling out a referral form to ensure it aligns with their specific guidelines and processes.

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What is specialist lymphoedema service referral?

Specialist lymphoedema service referral is a referral made by a healthcare provider to a specialized service for the management and treatment of lymphoedema.

Who is required to file specialist lymphoedema service referral?

Healthcare providers such as doctors, nurses, and therapists are required to file specialist lymphoedema service referral.

How to fill out specialist lymphoedema service referral?

To fill out a specialist lymphoedema service referral, healthcare providers must include the patient's personal information, medical history, and reason for referral.

What is the purpose of specialist lymphoedema service referral?

The purpose of specialist lymphoedema service referral is to ensure that patients with lymphoedema receive specialized care and treatment from experts in the field.

What information must be reported on specialist lymphoedema service referral?

Information such as patient's name, contact details, medical history, current symptoms, and reason for referral must be reported on specialist lymphoedema service referral.