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Developmental-Behavioral Pediatrics Fax Referrals to: (864) 241-9205 For Questions Call: (864) 454-5115 Date of Referral: Patient s Name: DOB: Social Security No (Patient): Gender: Street: Apt. #
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How to fill out developmental-behavioral pediatrics fax referrals
How to fill out developmental-behavioral pediatrics fax referrals:
01
Begin by gathering all necessary information about the patient, such as their personal details (name, date of birth, contact information), medical history, and any relevant test results or documentation.
02
Fill out the referral form provided by the developmental-behavioral pediatrics department, ensuring you provide accurate and complete information.
03
Clearly state the reason for the referral, including any specific concerns or symptoms that the patient is experiencing.
04
If applicable, include any relevant information about the referring healthcare provider, including their name, contact information, and signature.
05
Make sure to attach any supporting documents or test results that may aid in the evaluation process.
06
Double-check the completed referral form for any errors or missing information before faxing it to the designated recipient.
Who needs developmental-behavioral pediatrics fax referrals:
01
Children or adolescents who are experiencing developmental or behavioral issues, such as delayed milestones, social or communication difficulties, learning disabilities, or attention-deficit hyperactivity disorder (ADHD).
02
Parents or caregivers who have concerns about their child's development, behavior, or learning abilities and seek further evaluation or intervention.
03
Pediatricians, primary care physicians, or other healthcare providers who believe their patient would benefit from a specialized assessment and management plan provided by developmental-behavioral pediatricians.
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What is developmental-behavioral pediatrics fax referrals?
Developmental-behavioral pediatrics fax referrals are documents used to refer patients to specialists in pediatrics who focus on developmental and behavioral issues in children.
Who is required to file developmental-behavioral pediatrics fax referrals?
Healthcare providers, such as pediatricians or primary care physicians, are required to file developmental-behavioral pediatrics fax referrals.
How to fill out developmental-behavioral pediatrics fax referrals?
To fill out developmental-behavioral pediatrics fax referrals, healthcare providers need to provide patient information, reason for referral, and any relevant medical history or test results.
What is the purpose of developmental-behavioral pediatrics fax referrals?
The purpose of developmental-behavioral pediatrics fax referrals is to ensure that patients receive appropriate care and treatment for developmental and behavioral issues.
What information must be reported on developmental-behavioral pediatrics fax referrals?
Developmental-behavioral pediatrics fax referrals must include patient demographics, reason for referral, medical history, and any relevant test results or evaluations.
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