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GLENN BIGAMY IV, DO JEFFREY JAMES, DO 7780 S BROADWAY, SUITE 300 LITTLETON, CO 3039557574 PHONE 7202429307 FAX WWW.CCGYNONC.COM GYNECOLOGIC ONCOLOGY Referral Form Patient Name DOB Phone Alt Phone
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How to fill out gynecologic oncology referral psl
How to fill out gynecologic oncology referral psl
01
To fill out a gynecologic oncology referral PSL, follow these steps:
02
Gather patient information including name, age, contact details, and relevant medical history.
03
Specify the reason for referral and provide a brief summary of the patient's condition.
04
Include any pertinent test results or imaging reports that support the need for a gynecologic oncology evaluation.
05
Provide information about previous treatments or surgeries related to the patient's gynecologic condition.
06
Indicate any specific concerns or questions you have regarding the patient's case.
07
Include your contact information and preferred method of communication for further discussion or consultation.
08
Make sure to sign and date the referral form before sending it to the gynecologic oncology department.
Who needs gynecologic oncology referral psl?
01
Gynecologic oncology referral PSL is needed for individuals who:
02
- Have been diagnosed with or suspected to have gynecologic cancers such as ovarian, uterine, cervical, vaginal, or vulvar cancer.
03
- Require specialized evaluation, diagnosis, or treatment of gynecologic oncology conditions.
04
- Need a second opinion or consultation with gynecologic oncologists.
05
- Are referred by primary care physicians, obstetricians, or other healthcare providers who suspect a gynecologic malignancy.
06
- Have complex gynecologic conditions that may require the expertise of gynecologic oncology specialists.
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