Get the free Direct Referral For Screening Colonosopy

Queens Colon Screening Program (CSP) Direct Screening Colonoscopy Referral Form 550 South Batavia St. POB III Suite 701 Honolulu, HI 96813Office Phone: 6918270 / Fax: 6918278 Date of referral: / /

How to fill out direct referral for screening

How to fill out direct referral for screening

1. To fill out a direct referral for screening, follow these steps:
2. Start by obtaining the referral form from the screening facility or healthcare provider.
3. Fill out your personal information accurately, including your name, date of birth, contact details, and address.
4. Provide any relevant medical history or information that can assist the screening facility in evaluating your condition.
5. Specify the type of screening you require and provide any additional details or specific concerns.
6. If there are specific tests or screenings recommended by your healthcare provider, mention them in the referral form.
7. Review the completed form for any errors or missing information.
8. Submit the referral form to the designated screening facility or the healthcare provider's office as instructed.
9. Keep a copy of the referral form for your records.
10. Follow up with the screening facility to confirm receipt of the referral and to schedule an appointment if required.

Who needs direct referral for screening?

1. Direct referral for screening is typically needed by individuals who:
2. - Have a suspected medical condition that requires specialized screening or diagnostic tests.
3. - Need follow-up screenings as per their healthcare provider's recommendations.
4. - Require screening as part of routine preventive healthcare measures.
5. - Have been referred by another healthcare professional or specialist for specific screenings.

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