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SAM & IDA ROSS MEMORY CLINIC REFERRAL FORM 3560 Bathurst Street 6th Floor, Brain Health Complex Toronto, Ontario M6A 2E1 TEL: (416) 785-2444 FAX: (416) 785-2484 Please note that the Memory Clinic
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How to fill out toronto memory clinic referral
How to fill out baycrest memory clinic referral:
01
Obtain the referral form: Contact the Baycrest memory clinic or visit their website to obtain the referral form. They may have it available for download or can send it to you through email or regular mail.
02
Fill in the patient's information: Provide the patient's full name, address, contact information, and date of birth. It is important to ensure accuracy in this section to avoid any confusion.
03
Include the referring physician's information: Provide the name, address, contact information, and specialty of the physician referring the patient to the clinic. This helps the clinic keep records and communicate with the referring physician if necessary.
04
Mention the reason for referral: In this section, briefly describe the reasons why the patient is being referred to the Baycrest memory clinic. Include any relevant symptoms, medical history, or concerns that have led to this referral.
05
Attach supporting documents: If there are any relevant medical reports, test results, or imaging studies that support the referral, make sure to attach copies of these documents to the referral form. This can provide additional information to the clinic's healthcare team.
06
Sign and date the referral: Read through the form carefully and ensure that it is properly filled out. Then, sign and date the referral form to verify that the information provided is accurate and complete.
07
Submit the referral: Send the completed referral form along with any supporting documents to the Baycrest memory clinic using the preferred method mentioned by the clinic. This may include mailing the form or submitting it electronically through their website or email.
Who needs Baycrest memory clinic referral:
01
Patients with memory problems: Individuals experiencing memory impairments, such as forgetfulness, confusion, or difficulty performing daily tasks, may require a referral to the Baycrest memory clinic. These symptoms could be indicative of underlying cognitive issues that need evaluation and treatment.
02
Individuals with concerns about cognitive health: Anyone, including family members or friends, who has concerns regarding the cognitive health of a loved one can seek a referral to the Baycrest memory clinic. This can help in assessing and addressing potential cognitive impairments or conditions.
03
Healthcare professionals: Physicians or other healthcare providers who suspect cognitive impairments in their patients can refer them to the Baycrest memory clinic. These professionals can collaborate with the clinic's multidisciplinary team in diagnosing and managing cognitive disorders.
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What is baycrest memory clinic referral?
Baycrest memory clinic referral is a process where individuals are referred to Baycrest for memory assessment and care.
Who is required to file baycrest memory clinic referral?
Healthcare providers, family members, or individuals concerned about memory-related issues can file a Baycrest memory clinic referral.
How to fill out baycrest memory clinic referral?
Baycrest memory clinic referral can be completed by contacting Baycrest directly or through a healthcare provider.
What is the purpose of baycrest memory clinic referral?
The purpose of Baycrest memory clinic referral is to assess memory-related issues and provide appropriate care and support.
What information must be reported on baycrest memory clinic referral?
Information such as personal details, medical history, memory concerns, and contact information must be reported on Baycrest memory clinic referral.
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