Get the free gastroenterology request for referral - WakeMed Physicians

GASTROENTEROLOGY 3024 New Bern Avenue Suite 301 Raleigh, NC 27610 Phone: 9193506484 Fax: 9193507771 PROVIDERS: (Please check if referring to a specific provider.) Adam Laval, MD Ritz Chowdhury, MD

How to fill out gastroenterology request for referral

How to fill out a gastroenterology request for referral:

1. Start by obtaining the necessary forms from your primary care physician or healthcare provider. These forms can typically be downloaded from their website or obtained in person.
2. Fill out your personal information accurately, including your full name, date of birth, contact information, and insurance details. This information is crucial for properly identifying and contacting you.
3. Provide a detailed description of your symptoms and medical history. Include any relevant information such as previous diagnoses, medications you are currently taking, and any allergies you have. This will help the gastroenterologist make an informed decision about your care.
4. Indicate the reason for the referral. Explain why you are seeking a gastroenterology consultation and any specific concerns or issues you would like the specialist to address.
5. If you have seen any other healthcare professionals or specialists regarding your condition, include their contact information and any relevant medical records. This will help the gastroenterologist understand the full context of your situation.
6. Sign and date the form to acknowledge that the information provided is accurate to the best of your knowledge. Make sure to review the form carefully before submitting it to avoid any mistakes or missing information.

Who needs a gastroenterology request for referral:

1. Individuals experiencing gastrointestinal symptoms such as abdominal pain, bloating, indigestion, diarrhea, constipation, or unexplained weight loss.
2. Patients with a family history of gastrointestinal disorders or diseases such as colorectal cancer, Crohn's disease, or ulcerative colitis.
3. Individuals who have previously been diagnosed with a gastrointestinal condition and require further evaluation or specialized care.
4. Patients with abnormal results from diagnostic tests such as imaging studies, blood work, or stool samples that indicate a potential gastrointestinal issue.
5. Those referred by their primary care physician or healthcare provider who suspect an underlying gastrointestinal problem and want it to be thoroughly evaluated by a gastroenterologist.

It is important to consult with your primary care physician or healthcare provider to determine if a gastroenterology referral is necessary based on your specific symptoms and medical history.

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