Get the free dhmc referral forms

Physician Connection Line Toll free: 1-866-DHMC DOC (346-2362) Locally, dial: (603) 653-1999 Fax: (603) 676-4080 Referral Form Adult Hypertension/Nephrology Clinic To initiate, expedite, and/or coordinate

How to fill out dhmc referral forms

How to fill out a hypertension nephrology referral form:

1. Start by providing your personal information, including your full name, contact details, and date of birth.
2. Next, indicate the reason for the referral, specifically mentioning hypertension and nephrology as the requested specialty.
3. Describe any relevant medical history, including any diagnoses or treatments you have received for hypertension or kidney-related issues.
4. If you have any pertinent lab results or imaging reports, attach them to the referral form or provide copies as requested.
5. Include a brief summary of your current symptoms or concerns related to hypertension or nephrology. Be specific and concise in describing your condition.
6. If you have any medications or supplements that you are currently taking for hypertension or kidney-related conditions, list them on the form.
7. Finally, sign and date the referral form to verify its authenticity and completeness.

Who needs a hypertension nephrology referral form:

1. Individuals who have been diagnosed with hypertension and require specialized treatment or evaluation in the field of nephrology.
2. Patients with kidney disease or kidney-related problems, such as chronic kidney disease, renal dysfunction, or kidney stones, who would benefit from a hypertension nephrology specialist's expertise.
3. Individuals who have been referred by their primary care physician or another healthcare provider due to suspected or confirmed hypertension or kidney-related issues.

For pdfFiller’s FAQs

Can I create an electronic signature for signing my dhmc referral forms in Gmail?

Use pdfFiller's Gmail add-on to upload, type, or draw a signature. Your dhmc referral forms and other papers may be signed using pdfFiller. Register for a free account to preserve signed papers and signatures.

How do I edit dhmc referral forms straight from my smartphone?

The pdfFiller mobile applications for iOS and Android are the easiest way to edit documents on the go. You may get them from the Apple Store and Google Play. More info about the applications here. Install and log in to edit dhmc referral forms.

How do I edit dhmc referral forms on an Android device?

The pdfFiller app for Android allows you to edit PDF files like dhmc referral forms. Mobile document editing, signing, and sending. Install the app to ease document management anywhere.

What is hypertensionnephrology referral form?

Hypertensionnephrology referral form is a document used to refer patients with hypertension or kidney related issues to a nephrology specialist for further evaluation and treatment.

Who is required to file hypertensionnephrology referral form?

Healthcare providers, general practitioners, or specialists who diagnose patients with hypertension or kidney problems are required to file hypertensionnephrology referral form.

How to fill out hypertensionnephrology referral form?

To fill out hypertensionnephrology referral form, healthcare providers need to provide patient information, medical history, diagnosis, reason for referral, and any relevant test results.

What is the purpose of hypertensionnephrology referral form?

The purpose of hypertensionnephrology referral form is to facilitate the referral process for patients with hypertension or kidney issues to receive specialized care from a nephrology specialist.

What information must be reported on hypertensionnephrology referral form?

Patient demographics, medical history, diagnosis, reason for referral, current medications, and relevant test results must be reported on hypertensionnephrology referral form.