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FRENCHLANGUAGESYSTEM
EXTERNAL/SELFREFERRALFORMCulturalandlinguisticneedsaresocialdeterminantsofhealth. TheFrenchLanguageSystem(FLS)Navigatorisacare
providerwhoservesNorthSimcoeMuskoka. TheNavigatorhelpsFrancophoneandFrenchspeakingpeopleidentify
theirhealthandwellnessneedsandgoals.
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How to fill out fls external referral form
How to fill out fls external referral form
01
Step 1: Download the FLS External Referral Form from the official website.
02
Step 2: Fill out the patient's personal information including name, date of birth, contact details, and health insurance information.
03
Step 3: Provide a brief description of the patient's medical condition and reason for referral.
04
Step 4: Include any relevant medical history or test results that may assist the referral process.
05
Step 5: Specify the preferred specialist or healthcare provider for the referral.
06
Step 6: Sign and date the form to certify the accuracy of the information provided.
07
Step 7: Submit the completed form to the appropriate department or healthcare facility.
Who needs fls external referral form?
01
The FLS External Referral Form is needed by healthcare professionals or individuals who wish to refer a patient to a specialist or healthcare provider for further evaluation or treatment.
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What is fls external referral form?
The FLS external referral form is a document used to refer a case to an external agency for further investigation or action.
Who is required to file fls external referral form?
Any individual or organization that has knowledge of a case that requires external investigation or action.
How to fill out fls external referral form?
The form must be completed with all relevant information about the case and the reasons for the referral.
What is the purpose of fls external referral form?
The purpose of the form is to ensure that cases that require external intervention are properly referred and addressed.
What information must be reported on fls external referral form?
The form must include details about the case, the parties involved, and the reasons for the referral.
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