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Get the free WSP-PEDIATRIC SURGERY REQUEST FOR REFERRAL

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PEDIATRIC SURGERY 10000 Falls of Reuse Road Suite 206 Raleigh, NC 27614 Phone: 9193501604 Fax: 9193501404 PROVIDERS: (Please check if referring to a specific provider.) Duncan Phillips, MD George
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How to fill out wsp-pediatric surgery request for

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How to Fill Out WSP-Pediatric Surgery Request Form:

01
Start by gathering all necessary information: Make sure you have the patient's full name, date of birth, and contact information. Additionally, you will need the referring physician's details, including their name and contact information.
02
Complete the patient information section: Fill in the patient's name, date of birth, and any other relevant personal details requested on the form. Double-check that you have accurately entered all information.
03
Provide a detailed medical history: In the designated section, include any relevant medical history, including past surgeries, allergies, or pre-existing medical conditions. Be as thorough as possible to help the medical team assess the case appropriately.
04
Specify the reason for the surgery request: Clearly state the primary reason for the pediatric surgery request. Include any additional context or relevant information that might assist the medical team in understanding the urgency and necessity of the procedure.
05
Attach supporting documents, if required: Some pediatric surgery requests may require supporting medical documents or test results. Ensure that you have gathered all necessary paperwork and securely attach them to the request form. Include a brief explanation of each document's relevance.
06
Indicate if any special requirements are needed for the surgery: If the pediatric surgery request has any specific requirements or considerations, note them down clearly in the designated section. This might include dietary restrictions, specific equipment needed, or requested medical professionals.

Who Needs WSP-Pediatric Surgery Request Form:

01
Parents or legal guardians: If the patient is a minor, their parent or legal guardian will typically need to fill out the WSP-Pediatric Surgery Request Form on their behalf.
02
Referring physicians: In cases where a pediatric specialist is referring a patient for surgery, the referring physician will also need to complete the form.
03
Pediatric surgeons or hospital administrators: To ensure accurate and timely scheduling of the surgery, the pediatric surgeon or hospital administrators may need to review and process the completed WSP-Pediatric Surgery Request Form.
In conclusion, the WSP-Pediatric Surgery Request Form should be filled out accurately and comprehensively. It requires specific patient information, medical history, reason for the surgery request, and any supporting documents. The form is typically completed by parents or legal guardians of minors, referring physicians, and pediatric surgeons or hospital administrators.
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The wsp-pediatric surgery request is for requesting surgical procedures for pediatric patients.
Medical professionals, such as pediatric surgeons or medical administrators, are required to file the wsp-pediatric surgery request.
The wsp-pediatric surgery request form must be completed with all relevant patient information, physician details, and details of the surgical procedure.
The purpose of the wsp-pediatric surgery request is to ensure proper documentation and approval of pediatric surgical procedures.
The wsp-pediatric surgery request must include patient's name, age, medical history, procedure details, surgeon's information, and any relevant attachments.
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Relevant keywords

WSP wakemedphysicians Wadie Duncan Phillips NC Raleigh Neuse DOB applicable PROVIDERS REFERRAL notification electronically MD Consultation Faxed provider PEDIATRIC

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