Get the free UTOSM Referral Form

Referral/Forms. Here are a list of the forms that may be useful to you. Please click to download. Submission instructions can be found at the bottom of each form.

How to fill out utosm referral form

How to fill out utosm referral form

1. Step 1: Start by obtaining a copy of the UTOSM referral form.
2. Step 2: Fill in the patient's personal information, including their name, date of birth, and contact details.
3. Step 3: Provide the referring physician's information, such as their name, clinic address, and contact number.
4. Step 4: Specify the reason for the referral and the medical condition or injury being addressed.
5. Step 5: Indicate any relevant medical history or previous treatments the patient has undergone.
6. Step 6: Include any diagnostic tests or imaging results that support the need for referral.
7. Step 7: If applicable, provide details about the preferred timing or urgency for the referral.
8. Step 8: Sign and date the referral form to validate the information provided.
9. Step 9: Submit the completed referral form to the appropriate UTOSM department or healthcare professional.
10. Step 10: Keep a copy of the referral form for your records.

Who needs utosm referral form?

1. Patients who require specialized orthopedic care or sports medicine services may need a UTOSM referral form.
2. Referring physicians or healthcare professionals who want to recommend their patients for UTOSM's expertise would also need this referral form.
3. Individuals seeking consultations, surgeries, or treatments related to orthopedic conditions and injuries can benefit from completing a UTOSM referral form.

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What is utosm referral form?

The utosm referral form is a document used to refer a patient to the University of Toronto Orthopaedic Sports Medicine (UTOSM) for further evaluation and treatment.

Who is required to file utosm referral form?

Physicians, healthcare providers, or medical professionals recommending a patient for orthopaedic sports medicine treatment are required to file the utosm referral form.

How to fill out utosm referral form?

The utosm referral form can be filled out by providing the patient's personal information, medical history, reason for referral, and any relevant imaging or test results.

What is the purpose of utosm referral form?

The purpose of the utosm referral form is to facilitate the referral process and ensure that the patient receives timely and appropriate orthopaedic sports medicine care.

What information must be reported on utosm referral form?

The utosm referral form must include the patient's name, date of birth, contact information, insurance details, medical history, current symptoms, and referring provider information.