Get the free Referral Form - Tufts Health Plan

Massachusetts/New Hampshire chapterTUFTS HEALTH PLAN PROJECT Referral Form This form is to be used for Tufts Health Plan member referrals to the Dementia Care Consultant. Once complete, please email

How to fill out referral form - tufts

How to fill out referral form - tufts

1. To fill out a referral form for Tufts, follow these steps: 1. Start by obtaining a copy of the referral form from the Tufts website or by contacting the Tufts office directly.
2. Fill in the patient's personal information, including their name, date of birth, address, and contact details.
3. Provide the referring doctor's information, such as their name, contact details, and medical license number.
4. Specify the reason for the referral and the type of specialist or department needed.
5. Include any relevant medical history or diagnostic test results that may assist in the referral process.
6. If necessary, attach any supporting documents, such as imaging reports or lab results.
7. Review the completed referral form for accuracy and completeness.
8. Submit the referral form to the designated contact person or department at Tufts, following the specified submission method (e.g., online submission, fax, or mail).
9. Keep a copy of the referral form for your records.
10. Follow up with the patient to ensure they have received the necessary appointments or further instructions from Tufts.

Who needs referral form - tufts?

1. Anyone who requires specialized medical care or services from Tufts may need to fill out a referral form. This may include individuals who have been referred by their primary care physician, individuals seeking a second opinion, or those who require specialized services not offered by their current healthcare provider. It is recommended to consult with your healthcare provider or the Tufts office directly to determine if a referral form is necessary for your specific situation.

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What is referral form - tufts?

Referral form - tufts is a document used to refer patients to specialists or other healthcare providers within the Tufts network.

Who is required to file referral form - tufts?

Healthcare providers within the Tufts network are required to file referral form - tufts for their patients.

How to fill out referral form - tufts?

Referral form - tufts can be filled out electronically or manually by providing patient information, reason for referral, and specialist details.

What is the purpose of referral form - tufts?

The purpose of referral form - tufts is to ensure coordinated care for patients and facilitate communication between healthcare providers.

What information must be reported on referral form - tufts?

Referral form - tufts must include patient demographics, reason for referral, referring provider information, specialist details, and any relevant medical history.