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OSTEOPOROSIS phone 866.437.6717 fax 866.550.7421 1216 West Main St. Lexington, SC 29072 longsrx.com DATE: NEEDS BY DATE: SHIP TO:o Patients OFFICE FIRST OUTPATIENT Information OFFICE ALL Doses OTHER
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01
To fill out a rheum-osteoporosis referral form, follow these steps:
02
Begin by entering the patient's information, including their name, date of birth, and contact information.
03
Provide details about the referring healthcare professional, such as their name, specialty, and contact information.
04
Specify the reason for the referral, which in this case would be for rheum-osteoporosis evaluation.
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Include any relevant medical history, such as previous diagnoses, treatments, or medications.
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Provide a brief summary of the patient's symptoms and any specific concerns or findings.
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Indicate any additional tests or imaging that have been performed or are requested.
08
If applicable, mention any medications or therapies that have been tried and their effectiveness.
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Include any other relevant information that might assist the specialist in evaluating the patient's condition.
10
Sign and date the referral form as the referring healthcare professional.
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Make a copy of the completed referral form for your records and ensure it is sent to the appropriate specialist or healthcare facility.

Who needs rheum - osteoporosis referral?

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Several individuals may need a rheum-osteoporosis referral, including:
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- Patients who are experiencing symptoms or risk factors associated with rheumatological or osteoporotic conditions.
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- Those with a family history of rheum-osteoporosis or related disorders.
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- Individuals who have had previous fractures or bone density deficiencies.
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- Patients who require specialized evaluation or treatment options not available in their primary care setting.
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- Anyone with an existing rheumatological condition and suspected osteoporosis or vice versa.
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- Individuals who have been prescribed medications known to affect bone health and require monitoring.
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- People with chronic inflammatory diseases or autoimmune disorders that may impact bone health.
09
- Older adults, especially postmenopausal women, who are at a higher risk of developing osteoporosis.
10
- Those identified as high-risk individuals through routine screenings, such as bone density tests.
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A referral made by a healthcare provider to a rheumatologist or osteoporosis specialist for further evaluation and management.
Healthcare providers such as primary care physicians, specialists, or nurse practitioners may be required to file the referral.
The referral can be filled out by providing the patient's medical history, relevant symptoms, and any previous test results.
The purpose is to ensure that patients with rheumatic diseases or osteoporosis receive specialized care from a rheumatologist or osteoporosis specialist.
Information such as the patient's demographics, medical history, relevant symptoms, current medications, and any previous test results may need to be reported on the referral.
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