Get the free COMPLEX WOUND CLINIC REFERRAL FORM

COMPLEX WOUND CLINIC REFERRAL FORM VANCOUVER GENERAL HOSPITAL Gordon & Leslie Diamond Health Care Center rd 3 Floor, 2775 Laurel Street, Vancouver, BC Phone: 604.875.5866 Ext 5 Fax: 604.875.5861PLEASE

How to fill out complex wound clinic referral

How to fill out complex wound clinic referral

1. Step 1: Gather all necessary medical documentation, including patient history, lab results, and imaging reports.
2. Step 2: Review the referral form and fill out all required fields, such as patient's personal information, primary care physician details, and reason for referral.
3. Step 3: Provide detailed information about the wound, including its location, size, stage, and any associated symptoms or complications.
4. Step 4: Include a summary of previous treatments and their outcomes, including medications, dressings, and procedures used.
5. Step 5: Specify any additional concerns or expectations for the wound clinic team, such as desired treatment modalities or specific specialists to be involved.
6. Step 6: Ensure all contact information is accurate and up to date, including phone numbers, emails, and mailing addresses for both the patient and referring healthcare provider.
7. Step 7: Double-check the referral form for completeness and accuracy before submitting it to the complex wound clinic.
8. Step 8: Follow any additional instructions provided by the specific clinic or healthcare organization for submitting the referral.
9. Step 9: Maintain ongoing communication with the wound clinic team regarding the patient's progress and any changes in their condition.

Who needs complex wound clinic referral?

1. Patients with difficult or non-healing wounds that require specialized wound care interventions
2. Patients with complex wound etiologies, such as diabetic foot ulcers, venous stasis ulcers, or pressure ulcers
3. Patients with wounds that have not responded to initial treatments or have shown signs of infection or complications
4. Patients with underlying medical conditions that may contribute to impaired wound healing, such as diabetes, peripheral artery disease, or autoimmune disorders
5. Patients with wounds requiring advanced wound care techniques, such as negative pressure wound therapy, wound debridement, or advanced wound dressings
6. Patients who may benefit from a multidisciplinary approach to wound care, involving various healthcare professionals like wound care nurses, vascular specialists, and plastic surgeons.

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