Get the free Diabetes Team Referral Form - Salford Diabetes Care

Referral to Diabetes Specialist Team NHS Number Name: D.O.B: Address: Postcode: Tel No: GP Details Date of diagnosis of diabetes: Please ensure recent height, weight, BMI and blood pressure information

How to fill out diabetes team referral form

Who needs diabetes team referral form?

1. Individuals diagnosed with diabetes who require specialized care and treatment from a diabetes team.
2. This form is typically used by primary care doctors or healthcare providers to refer their patients to a diabetes team.

How to fill out a diabetes team referral form?

1. Start by providing your personal information, including your name, date of birth, address, and contact details.
2. Indicate your current healthcare provider or primary care doctor who is referring you to the diabetes team.
3. Specify the reason for the referral, mentioning that it is for diabetes management and treatment.
4. Include any relevant medical history, such as previous diagnoses, medications you are currently taking, and any complications or comorbidities related to diabetes.
5. If you have seen any other specialists or received previous diabetes-related care, mention their names and contact information.
6. Provide any relevant test results or laboratory reports related to your diabetes, such as blood sugar levels, HbA1c values, or kidney function tests.
7. Include any additional information or specific concerns you would like the diabetes team to address during your consultation or treatment.
8. Sign and date the referral form, confirming your consent to share your medical information with the diabetes team.

By following these steps, you can accurately fill out a diabetes team referral form, ensuring that all necessary information is included for a seamless referral and smooth transition to diabetes specialist care.

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What is diabetes team referral form?

Diabetes team referral form is a form used to refer a patient to a specialized team of healthcare professionals who can provide comprehensive care for diabetes management.

Who is required to file diabetes team referral form?

Healthcare providers, such as primary care physicians or endocrinologists, are required to file the diabetes team referral form for their patients who require specialized care for diabetes.

How to fill out diabetes team referral form?

The diabetes team referral form typically requires information about the patient's medical history, current diabetes management plan, and reason for referral. Healthcare providers can fill out the form and submit it to the specialized team.

What is the purpose of diabetes team referral form?

The purpose of the diabetes team referral form is to ensure that patients with diabetes receive comprehensive and specialized care from a team of healthcare professionals who are trained in managing the condition.

What information must be reported on diabetes team referral form?

The diabetes team referral form may require information such as the patient's demographics, medical history, current medications, diabetes treatment plan, and any specific concerns or goals for diabetes management.