Get the free Respiratory Therapy Clinical Referral Form for STCH - 2015 06 01.doc

Community Respiratory Services Requisition Stratton Community Hospital Allied Health Edmonton Zone Requisition Not Valid Unless Signed By Physician Date: PhD: Patient Name: Patient home phone: DOB:

How to fill out respiratory therapy clinical referral

How to fill out respiratory therapy clinical referral

1. Step 1: Gather necessary information such as patient's demographics, medical history, and insurance details.
2. Step 2: Review the specific requirements of the clinical referral form provided by the respiratory therapy department.
3. Step 3: Fill out the patient's name, date of birth, and contact information accurately.
4. Step 4: Provide details about the referring healthcare professional, including their name and contact information.
5. Step 5: Specify the reason for the referral and include any relevant diagnosis or medical conditions.
6. Step 6: Fill in information related to the specific respiratory therapy services requested or required.
7. Step 7: If applicable, include any additional notes or special instructions for the respiratory therapist.
8. Step 8: Review the completed referral form for any errors or missing information.
9. Step 9: Sign and date the referral form, ensuring that the signature matches the referring healthcare professional's official signature.
10. Step 10: Submit the completed referral form to the designated respiratory therapy department or healthcare provider.

Who needs respiratory therapy clinical referral?

1. Patients with respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), or pneumonia may need respiratory therapy clinical referral.
2. Individuals who require specialized respiratory treatments, such as oxygen therapy or nebulizer treatments, may also need a clinical referral.
3. Patients who have undergone surgery or experienced lung-related injuries may benefit from respiratory therapy and require a clinical referral.
4. People with respiratory conditions who require assistance with breathing exercises, airway clearance techniques, or ventilator support may also need a referral.
5. Individuals who need pulmonary function tests, such as spirometry or arterial blood gas analysis, may be referred for respiratory therapy.
6. Patients who need education on respiratory management, inhaler techniques, or smoking cessation may benefit from respiratory therapy and require a clinical referral.

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What is respiratory therapy clinical referral?

Respiratory therapy clinical referral is a process where healthcare providers refer patients to respiratory therapists for evaluation and treatment of respiratory conditions.

Who is required to file respiratory therapy clinical referral?

Healthcare providers such as physicians, nurses, and other allied health professionals are required to file respiratory therapy clinical referral.

How to fill out respiratory therapy clinical referral?

Respiratory therapy clinical referral can be filled out by providing patient information, medical history, reason for referral, and any other relevant details.

What is the purpose of respiratory therapy clinical referral?

The purpose of respiratory therapy clinical referral is to ensure that patients with respiratory problems receive appropriate evaluation and treatment from respiratory therapists.

What information must be reported on respiratory therapy clinical referral?

Information such as patient demographics, medical history, respiratory symptoms, and reason for referral must be reported on respiratory therapy clinical referral.