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Continuity of Care Consultation Sheet This form is provided to facilitate communication between behavioral health and primary care physicians to enhance continuity and coordination of care. Please
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How to fill out continuity of care bconsultation:

01
Start by providing your personal information, such as your name, contact details, and any identifying numbers or codes required.
02
Indicate the reason for the consultation and provide a brief background or history of your medical condition or situation, including any relevant dates.
03
Include the names and contact information of your previous healthcare providers or facilities, as well as the dates of your previous interactions or treatments.
04
Specify the details of your current healthcare provider or facility, including their name, contact information, and any relevant dates of your ongoing treatment or care.
05
Describe any specific concerns or issues you have regarding the continuity of your care and any areas where you feel that there may be gaps or inconsistencies.
06
List any medications, treatments, or procedures you are currently undergoing or have recently completed, including the dosage, frequency, and duration, if applicable.
07
Provide any relevant medical records, test results, or documentation that support your need for continuity of care and help the recipient of the consultation understand the full context of your situation.
08
Sign and date the consultation form, acknowledging that the information provided is accurate and complete to the best of your knowledge.

Who needs continuity of care bconsultation?

01
Patients who have transitioned from one healthcare provider or facility to another, such as moving to a new city or changing insurance plans, may need continuity of care consultation.
02
Individuals with chronic or complex medical conditions who require ongoing, specialized care from multiple healthcare providers may benefit from continuity of care consultation.
03
Patients who have experienced gaps or disruptions in their healthcare due to various reasons, such as hospitalization, emergency room visits, or change in providers, could benefit from continuity of care consultation.
04
Individuals who suspect that their medical information or treatment history has been compromised or lost may need continuity of care consultation to ensure that all relevant information is shared with their current healthcare provider.
05
Patients who are seeking a second opinion or want to transfer their care to a new provider may require continuity of care consultation to ensure a smooth transition and comprehensive understanding of their medical history.
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Continuity of care consultation is a process that ensures a patient's care is coordinated and consistent across different healthcare providers and settings.
Healthcare providers, hospitals, and other organizations involved in a patient's care are required to file continuity of care consultation.
Continuity of care consultation can be filled out by documenting the patient's medical history, current treatment plans, and any changes in care providers.
The purpose of continuity of care consultation is to ensure that patients receive seamless and coordinated care, leading to better health outcomes.
Information such as patient demographics, medical history, current medications, allergies, and treatment plans must be reported on continuity of care consultation.
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