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Draft Jan 25 2016 INFECTIOUS DISEASE CONSULT SERVICE TO OUTPATIENT CLINIC REFERRAL FORM Must be completed for ALL inpatient referrals ADDRESSOGRAPH INSTRUCTIONS b. Health Sciences Centre St. Boniface General Hospital Dr. F. Aoki. 204-7877086 Dr. J. Embil.. 204-787-7086 AND 7872989 Dr. E. Lo. 204-233-7125 Dr. T. Wuerz. 204-233-7125 Other 2. ANTIMICROBIAL THERAPY AT DISCHARGE CIVP PATIENT YES NO I. MEDICATION DOSE FREQUENCY DURATION OR END DATE II. 3. TIME LINE FOR FOLLOW-UP 4....
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01
Gather all relevant medical records and test results of the patient.
02
Contact the infectious disease consult service team and schedule an appointment.
03
Provide all necessary information about the patient's condition, including symptoms, medical history, and any previous treatments.
04
During the appointment, discuss the patient's case with the infectious disease specialist and provide additional details if required.
05
Follow the specialist's recommendations and treatment plan.
06
Regularly communicate with the infectious disease consult service to provide updates on the patient's progress and address any concerns or questions.
07
Adhere to the prescribed medication and treatment regimen.
08
Attend follow-up appointments as advised by the specialist.
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Discuss any changes in the patient's condition or response to treatment with the infectious disease consult service.
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Continue to seek guidance from the consult service until the patient's condition improves or is resolved.

Who needs infectious disease consult service?

01
Patients with complex or rare infectious diseases.
02
Individuals with recurring or persistent infections that are difficult to diagnose or treat.
03
Patients with compromised immune systems, such as those with HIV/AIDS or undergoing organ transplantation.
04
People with healthcare-associated infections.
05
Individuals who have recently traveled to high-risk areas or have been in contact with contagious individuals.
06
Individuals with suspected or confirmed outbreaks of infectious diseases.
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Patients with unexplained fevers or other symptoms that could be caused by an infectious disease.
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Healthcare professionals seeking expert advice on managing infectious diseases.
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Individuals who want a second opinion on their infectious disease diagnosis or treatment plan.
10
People interested in infectious disease prevention and vaccinations.
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Infectious disease consult service is a specialized medical service that provides consultation and treatment for patients with infectious diseases.
Healthcare providers, hospitals, and clinics are required to file infectious disease consult service for patients with infectious diseases.
To fill out infectious disease consult service, healthcare providers need to provide detailed information about the patient's medical history, symptoms, and laboratory test results.
The purpose of infectious disease consult service is to diagnose and treat patients with infectious diseases, prevent the spread of communicable diseases, and provide guidance on managing outbreaks.
Information such as patient demographics, medical history, symptoms, laboratory test results, diagnosis, treatment plan, and follow-up care must be reported on infectious disease consult service.
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