Get the free Geriatric Assessment Clinics Referral Form - Baycrest - baycrest

Geriatric Assessment Referral Form (PLEASE PRINT CLEARLY) REFERRAL TO: Dr. F. Varese ext. 2613 (Tina) Dr. S. Vanish ext. 2621 (Margaret) Dr. T. Yogaparan ext. 2620 (Belle) First Available Dr. H. Borrower

How to fill out geriatric assessment clinics referral

How to fill out geriatric assessment clinics referral:

1. Begin by providing your personal information, including your name, date of birth, and contact information. It is important to include accurate details to ensure proper communication.
2. Specify the reason for the referral clearly in a concise manner. Be sure to mention whether it is a routine assessment or if there are specific concerns that need to be addressed.
3. Include any relevant medical history and current medications you are taking. This information will help the geriatric assessment clinic understand your overall health and identify any potential interactions or concerns.
4. It is important to provide a brief summary of your current physical and mental health status. Mention any specific symptoms or concerns that you have been experiencing that led to the referral.
5. If you have any prior medical reports or test results that are relevant to your referral, make sure to attach them with the referral form. This will provide additional information for the clinic to better understand your condition.
6. Mention any specific preferences or circumstances that the clinic should be aware of, such as language preferences, disabilities, or mobility issues. Providing this information will help ensure that you receive appropriate and personalized care.
7. It is essential to obtain a signature from your primary care physician or referring healthcare professional. This signature confirms that the referral is authorized and medically necessary.

Who needs geriatric assessment clinics referral:

1. Older adults who require a comprehensive evaluation of their physical, mental, and functional health can benefit from a geriatric assessment clinics referral.
2. Individuals with complex medical conditions that require specialized care tailored to their age-related needs may be referred to a geriatric assessment clinic.
3. Older adults experiencing cognitive decline, memory problems, or suspected cases of dementia may be referred to a geriatric assessment clinic for a thorough evaluation and diagnostic assessment.
4. Patients with multiple chronic conditions or on numerous medications may be referred to a geriatric assessment clinic to optimize their care, minimize medication interactions, and improve overall health outcomes.
5. Caregivers or family members who have concerns about an older adult's well-being and want a comprehensive evaluation of their loved one's health and functional status may also be encouraged to seek a geriatric assessment clinics referral.

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What is geriatric assessment clinics referral?

Geriatric assessment clinics referral is a process where healthcare providers refer elderly patients to specialized clinics for comprehensive evaluations of their physical, mental, and social well-being.

Who is required to file geriatric assessment clinics referral?

Healthcare providers such as primary care physicians, specialists, and social workers are required to file geriatric assessment clinics referral for elderly patients who may benefit from a more thorough evaluation.

How to fill out geriatric assessment clinics referral?

To fill out a geriatric assessment clinics referral, healthcare providers need to gather relevant medical information about the patient, complete the referral form provided by the clinic, and ensure that the patient meets the criteria for referral.

What is the purpose of geriatric assessment clinics referral?

The purpose of geriatric assessment clinics referral is to assess the overall health and well-being of elderly patients, identify any existing or potential health issues, formulate a comprehensive care plan, and improve the quality of life for the patient.

What information must be reported on geriatric assessment clinics referral?

Information reported on geriatric assessment clinics referral may include the patient's medical history, current medications, functional status, cognitive abilities, social support network, and any specific concerns or goals for the assessment.