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SPECIAL CARE DENTAL SERVICE Patient Referral Form for use by General Dental Practitioners sections of this form must be fully completed to avoid unnecessary delays and incomplete forms will be returned.
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The patient referral form is used to refer a patient from one healthcare provider to another for specialized care or treatment.
Healthcare providers such as doctors, specialists, or hospitals are required to file the patient referral form.
The patient referral form can be filled out by providing the patient's basic information, reason for referral, relevant medical history, and contact information.
The purpose of the patient referral form is to ensure coordinated and appropriate care for the patient by facilitating communication between healthcare providers.
The patient referral form must include the patient's name, age, medical history, reason for referral, referring provider's information, and any relevant test results.
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