Get the free OUTPATIENT CONSULTATION REFERRAL

MENTAL HEALTH SERVICES OUTPATIENT CONSULTATION REFERRAL Please print and fax referrals to: 4164807842 Note for Sunny brook staff: when faxing referral forms within the hospital, please send faxes

How to fill out outpatient consultation referral

How to fill out outpatient consultation referral

1. To fill out an outpatient consultation referral, follow these steps:
2. Write the date on the top left corner of the referral form.
3. Fill in the patient's personal information, including their name, address, contact number, and date of birth.
4. Specify the reason for the consultation and provide any relevant medical history or findings.
5. Indicate the preferred specialist or department for the referral.
6. If necessary, attach any supporting documentation, such as test results or previous medical reports.
7. Sign and date the referral form at the bottom.
8. Submit the completed referral form to the appropriate healthcare provider or clinic.
9. Note: It is important to accurately fill out all required information to ensure smooth and efficient processing of the referral.

Who needs outpatient consultation referral?

1. Outpatient consultation referral is typically needed for patients who require specialized medical advice or treatment from a specialist or specialized department.
2. This includes individuals with complex or chronic health issues, those requiring further evaluation or specialized tests, or those seeking a second opinion.
3. Patients who have been referred by their primary care physician or general practitioner may also need an outpatient consultation referral.

For pdfFiller’s FAQs

What is outpatient consultation referral?

Outpatient consultation referral is a process where a healthcare provider refers a patient to another specialist or healthcare facility for further evaluation or treatment on an outpatient basis.

Who is required to file outpatient consultation referral?

The healthcare provider or physician who is referring the patient for outpatient consultation is required to file the referral.

How to fill out outpatient consultation referral?

To fill out an outpatient consultation referral, the healthcare provider must provide the patient's information, reason for referral, relevant medical history, and any other pertinent details.

What is the purpose of outpatient consultation referral?

The purpose of outpatient consultation referral is to ensure that patients receive appropriate and specialized care from other healthcare professionals or facilities.

What information must be reported on outpatient consultation referral?

The outpatient consultation referral must include patient's personal information, reason for referral, current medical condition, relevant medical history, and any supporting documentation.

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