Get the free NEUROREHABILITATION SERVICES INPATIENT REFERRAL FORM - stgeorgehealthcaregroup org

ST CYRIL REHABILITATION UNIT Countess of Chester Health Park, Liverpool Road, Chester CH2 1HJ Tel: 0808 1781900 Fax 01244 665331 NEUROREHABILITATION SERVICES INPATIENT REFERRAL FORM Please complete

How to fill out neurorehabilitation services inpatient referral

1. To fill out a neurorehabilitation services inpatient referral, start by gathering the necessary information about the patient. This may include their full name, contact information, date of birth, insurance details, and any relevant medical history.
2. Next, identify the reason for the referral and provide a detailed description of the patient's condition or diagnosis that requires neurorehabilitation services. Include any relevant test results, medical reports, or assessments that support the need for inpatient rehabilitation.
3. Specify the desired duration of the inpatient rehabilitation program and any specific goals or outcomes that are expected to be achieved through the neurorehabilitation services. This information helps the healthcare team determine the appropriate level of care and develop a tailored treatment plan for the patient.
4. Include any information related to the patient's current therapy or treatment regimen, such as ongoing medications, therapies, or interventions. This ensures continuity of care and helps providers understand the patient's existing treatment plan.
5. Ensure that the referral form is completed with accurate and up-to-date contact information for both the referring healthcare provider and the patient. This enables efficient communication and follow-up throughout the referral process.

Who needs neurorehabilitation services inpatient referral?

1. Patients with acute neurological conditions such as stroke, traumatic brain injury, spinal cord injury, or neurodegenerative diseases may require neurorehabilitation services. These conditions often result in functional impairments that can benefit from specialized inpatient rehabilitation programs.
2. Individuals who have undergone neurosurgical procedures, such as brain or spinal cord surgeries, may also require neurorehabilitation services to aid in their recovery and optimize their functional outcomes.
3. Patients with progressive neurological disorders, such as multiple sclerosis or Parkinson's disease, may benefit from inpatient neurorehabilitation to manage symptoms, improve mobility, and enhance overall quality of life.
4. Individuals with complex neurological conditions that require a multidisciplinary approach, involving various healthcare professionals such as physiatrists, neurologists, physical therapists, occupational therapists, and speech-language pathologists, may be suitable candidates for neurorehabilitation services.

Remember to consult with the patient's primary care physician or neurologist to determine the appropriateness of a neurorehabilitation services inpatient referral and to ensure that all necessary medical documentation is included in the referral process.

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