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Anticoagulation Clinic Referral Form (For the use of General Practitioners) PLEASE ensure that all sections are FULLY completed Section 1 Patient Details Name: DOB: Address: Hospital Number: NHS Number:
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What is anticoagulation clinic referral form?
The anticoagulation clinic referral form is a document used to refer patients to an anticoagulation clinic for specialized care and management of anticoagulant therapy.
Who is required to file anticoagulation clinic referral form?
Healthcare providers, such as physicians or nurse practitioners, who identify the need for anticoagulant therapy and believe that a patient would benefit from specialized care provided by an anticoagulation clinic, are required to file the referral form.
How to fill out anticoagulation clinic referral form?
To fill out the anticoagulation clinic referral form, healthcare providers should provide the necessary patient information, medical history, details of the current anticoagulant therapy, reason for the referral, and any other relevant information as required by the specific form.
What is the purpose of anticoagulation clinic referral form?
The purpose of the anticoagulation clinic referral form is to facilitate the referral process, ensuring that patients receive specialized care and management of their anticoagulant therapy from anticoagulation clinics with expertise in this area. It helps in coordinating care, monitoring anticoagulation levels, implementing dosage adjustments when necessary, and providing education and support to patients.
What information must be reported on anticoagulation clinic referral form?
The specific information required on the anticoagulation clinic referral form may vary, but generally, it includes patient demographics, medical history, current medications, coagulation parameters, reason for referral, referring healthcare provider's information, and any additional information deemed relevant for the referral.
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