Get the free Lower GI Endoscopy Referral Form April 2011 - MRI CTX

LOWER GI ENDOSCOPY REFERRAL FORM Please note we are unable to accept referrals for patients under 18 years of age PATIENT NHS Number Forename Surname Address REFERRER Name GMC/HPC/NMC No Address Date

How to fill out lower gi endoscopy referral

How to fill out a lower GI endoscopy referral:

1. Begin by providing your patient's personal information, including their full name, date of birth, and contact details.
2. Include relevant medical history, such as any pre-existing conditions or diseases that may impact the decision to perform a lower GI endoscopy.
3. Specify the reason for the referral, describing the patient's symptoms or concerns that warrant further investigation through a lower GI endoscopy.
4. Include any previous tests or procedures that have been conducted and their results, if applicable. This will provide the referring physician with valuable information to guide the next steps.
5. Indicate the urgency of the referral, especially if it is necessary to schedule the lower GI endoscopy promptly due to the patient's condition.
6. Provide any additional relevant information, such as allergies, medications the patient is currently taking, or specific instructions for the referral.

Who needs a lower GI endoscopy referral:

1. Patients who are experiencing persistent gastrointestinal symptoms, such as abdominal pain, rectal bleeding, unexplained weight loss, or changes in bowel habits.
2. Individuals with a family history of gastrointestinal diseases, such as colorectal cancer, Crohn's disease, or ulcerative colitis, may require a lower GI endoscopy referral for early detection or surveillance.
3. Patients who have previously undergone upper gastrointestinal endoscopy but still require further investigation of the lower gastrointestinal tract may need a referral for a lower GI endoscopy.

It is crucial to consult with a healthcare professional or a gastroenterologist who can evaluate each patient's specific symptoms and medical history to determine if a lower GI endoscopy referral is appropriate.

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