Saint Luke's Health System Kidney Transplant Referral 2016-2025 free printable template

4401 Worn all Road Kansas Cities, MO 64111 8169323550 office 8169323973 fax1035 N. Emporia, Suite 185 Wichita, KS 67214 3163031045 office 3163031026 kidney Transplant Referral Patient Information

How to fill out Saint Lukes Health System Kidney Transplant

How to fill out Saint Luke's Health System Kidney Transplant Referral

1. Obtain the Kidney Transplant Referral form from Saint Luke's Health System website or healthcare provider.
2. Fill out the patient’s personal information including name, date of birth, and contact details.
3. Provide medical history including details of current kidney disease and previous treatments.
4. Include information about current medications and allergies.
5. List any other healthcare providers involved in the patient’s care.
6. Sign and date the referral form to authorize submission.
7. Submit the completed referral form to the designated department at Saint Luke's Health System.

Who needs Saint Luke's Health System Kidney Transplant Referral?

1. Patients with chronic kidney disease who are eligible for a kidney transplant.
2. Individuals experiencing kidney failure requiring dialysis.
3. Patients with specific conditions leading to kidney dysfunction, such as diabetes or hypertension.
4. Candidates who have exhausted other treatment options and are seeking a kidney transplant.

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What is Saint Luke's Health System Kidney Transplant Referral?

Saint Luke's Health System Kidney Transplant Referral is a formal process used to refer patients who are potential candidates for kidney transplantation to the appropriate specialists within the Saint Luke's Health System.

Who is required to file Saint Luke's Health System Kidney Transplant Referral?

Healthcare providers, including nephrologists, primary care physicians, and specialists involved in the care of patients with kidney disease, are typically required to file a Saint Luke's Health System Kidney Transplant Referral.

How to fill out Saint Luke's Health System Kidney Transplant Referral?

To fill out the referral, healthcare providers need to complete a referral form that includes patient information, medical history, and details pertinent to the patient's kidney condition and overall health status.

What is the purpose of Saint Luke's Health System Kidney Transplant Referral?

The purpose of the referral is to evaluate the patient for kidney transplantation eligibility, coordinate care, and facilitate the transplant process if the patient is deemed a suitable candidate.

What information must be reported on Saint Luke's Health System Kidney Transplant Referral?

The information that must be reported includes patient demographics, medical history, current kidney function, comorbid conditions, and any previous treatments or interventions related to kidney disease.