Get the free Fax Referral Form - Accelerate CIC

FAX: 0208 223 8863 IMPORTANT: Call 0208 8331 to inform us that fax has been sent Lymphedema Referral Form Name: NHS No: Address: DOB: Date of referral: Ethnicity: Consultant s Name: (if applicable)

How to fill out fax referral form

How to fill out a fax referral form:

1. Begin by gathering all the necessary information for the referral. This may include the patient's name, contact information, medical history, and reason for referral.
2. Next, locate the fax referral form. This form is typically provided by the healthcare provider or facility initiating the referral.
3. Fill out the patient's personal information accurately and completely. Make sure to include their full name, date of birth, address, and phone number.
4. Provide the necessary medical details. This may include the referring physician's name, their contact information, and the details of the specialist or medical facility to which the patient is being referred.
5. Include any relevant medical history, such as previous diagnoses, treatments, medications, or allergies that may be pertinent to the referral.
6. Specify the reason for referral, describing the specific concerns or symptoms that prompted the referral. Be as thorough and concise as possible to ensure a clear understanding of the patient's needs.
7. Review the completed form for any errors or missing information. Double-check that all the required fields have been filled out accurately.
8. Once you are confident in the accuracy of the form, you can proceed to fax it. Ensure that the fax number is correctly entered and check that the fax machine is properly connected and operating.
9. Press the send button on the fax machine and wait for the confirmation receipt to ensure that the referral has been successfully transmitted.

Who needs fax referral form?

1. Healthcare providers: Doctors, specialists, or medical professionals who need to refer a patient to another healthcare provider or specialist.
2. Patients: Individuals who require specialized medical care or treatment beyond the scope of their primary healthcare provider may need a fax referral form to initiate the referral process.
3. Medical facilities: Hospitals, clinics, or healthcare centers that manage patient care and collaborate with other providers may use fax referral forms to facilitate efficient and effective communication.

Remember, the need for a fax referral form may vary depending on the healthcare system or specific requirements of individual medical professionals, so it is always advisable to consult with the healthcare provider or facility in question for guidance.

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What is fax referral form?

Fax referral form is a document used to refer a patient to a specialist or another healthcare provider via fax.

Who is required to file fax referral form?

Healthcare providers such as doctors, nurses, and medical staff are required to file fax referral form.

How to fill out fax referral form?

Fax referral form can be filled out by providing patient information, reason for referral, specialist information, and any relevant medical history.

What is the purpose of fax referral form?

The purpose of fax referral form is to ensure seamless communication between healthcare providers and to facilitate patient care.

What information must be reported on fax referral form?

Information such as patient name, date of birth, reason for referral, specialist details, and any relevant medical records must be reported on fax referral form.