Get the free Dry Eye Clinic Referral FormSchool of Optometry and Vision ...

UNSW DRY EYE CLINIC REFERRAL FORM PLEASE FAX TO 02 9313 8604Please complete this form if you wish to refer a patient to the UNSW Dry Eye Clinic and fax to us. Upon receipt, we will contact your patient

How to fill out dry eye clinic referral

How to fill out dry eye clinic referral

1. To fill out a dry eye clinic referral, follow these steps:
2. Obtain the referral form from the dry eye clinic or download it from their website.
3. Fill in the patient's personal information, including their name, address, phone number, and email.
4. Provide the patient's medical history, including any previous diagnoses or treatments for dry eye.
5. Specify the reason for the referral, such as persistent symptoms, worsening of symptoms, or the need for specialized dry eye treatment.
6. Include any relevant test results or imaging reports that support the need for the referral.
7. Sign and date the referral form.
8. Submit the completed referral form to the dry eye clinic through the designated method (e.g., in-person, fax, email).

Who needs dry eye clinic referral?

1. Individuals who are experiencing symptoms of dry eye and require specialized assessment and treatment may need a dry eye clinic referral. This includes patients who have tried over-the-counter remedies or conventional treatments without success, have persistent or worsening symptoms, or have underlying conditions or complications that require expert evaluation and management. It is recommended to consult with an eye care professional to determine if a dry eye clinic referral is necessary for a particular individual.

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What is dry eye clinic referral?

Dry eye clinic referral is a process where a patient is referred to a specialized clinic for the treatment and management of dry eye syndrome.

Who is required to file dry eye clinic referral?

Healthcare professionals such as ophthalmologists or optometrists are required to file dry eye clinic referrals for their patients.

How to fill out dry eye clinic referral?

To fill out a dry eye clinic referral, healthcare professionals need to provide the patient's information, medical history, and reason for referral.

What is the purpose of dry eye clinic referral?

The purpose of dry eye clinic referral is to ensure that patients with dry eye syndrome receive specialized care and treatment from experts in the field.

What information must be reported on dry eye clinic referral?

Information such as patient demographics, symptoms, previous treatments, and any relevant medical history must be reported on a dry eye clinic referral.