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F-2427 11-2011 Page 1 of 1 PLEASE FAX COMPLETED REFERRAL TO 416-323-7739 76 Grenville Street Toronto ON M5S 1B2 T 416. Name DOB HC REFERRAL FORM Telephone Address / Date YYYY/MM/DD MRN/Visit UHN only Referral Physician Expectations One time consultation Consider ongoing co-management for this issue s Urgent appointment requested Next available appointment OR Specific MD Other Referral From Ambulatory Internal Family Medicine Medicine Group Practice Emergency Sub-specialty Post-discharge...
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03
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04
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05
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06
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07
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What is mrnvisit uhn only?
MRNVisit UHN only is a specialized form for reporting hospital visits at University Health Network only.
Who is required to file mrnvisit uhn only?
Healthcare professionals who provide services at University Health Network are required to file MRNVisit UHN only forms.
How to fill out mrnvisit uhn only?
MRNVisit UHN only forms can be filled out electronically or manually by entering the required patient and visit information.
What is the purpose of mrnvisit uhn only?
The purpose of MRNVisit UHN only is to accurately report hospital visits at University Health Network for billing and tracking purposes.
What information must be reported on mrnvisit uhn only?
Patient's medical record number, date of visit, services provided, and any other relevant details must be reported on MRNVisit UHN only.
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