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HAN Diabetes Care ServiceRevised March 2019Sudbury Outpatient Center, Second Floor 865 Regent St. S Sudbury ON P3E 3Y9 Phone: 7056716601 Fax referrals to 7056715634 or email to: diabetescareservice
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How to fill out diabetes care services-self referral
How to fill out diabetes care services-self referral
01
Obtain the self-referral form for diabetes care services from your healthcare provider or download it from their website.
02
Fill out all the required personal information fields such as your name, address, contact number, and date of birth.
03
Provide your medical history related to diabetes, including any previous diagnoses, treatments, and medications you are currently taking.
04
Specify the reason for your self-referral and describe any specific concerns or symptoms you may be experiencing.
05
If you have any preferences for healthcare providers or specialists, indicate them in the appropriate section.
06
Ensure that you have filled out all the necessary fields completely and accurately.
07
Submit the completed self-referral form to the designated healthcare provider, either in-person or through the specified submission method.
08
Follow up with the healthcare provider to confirm receipt of your self-referral and to schedule any necessary appointments or consultations.
09
Keep a copy of the self-referral form for your records.
10
If you do not receive a response within a reasonable time, contact the healthcare provider to inquire about the status of your self-referral.
Who needs diabetes care services-self referral?
01
Individuals who have been diagnosed with diabetes or suspect they may have diabetes.
02
Individuals who require specialized diabetes care services and want to seek assistance or treatment.
03
Individuals who want to self-refer themselves for diabetes care instead of going through a healthcare provider referral.
04
Individuals who prefer a more streamlined and direct process for accessing diabetes care services.
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What is diabetes care services-self referral?
Diabetes care services-self referral is a process where individuals can refer themselves to receive care and services related to diabetes.
Who is required to file diabetes care services-self referral?
Individuals who are seeking care and services related to diabetes are required to file diabetes care services-self referral.
How to fill out diabetes care services-self referral?
To fill out diabetes care services-self referral, individuals need to provide their personal information, details about their diabetes condition, and any specific care needs they have.
What is the purpose of diabetes care services-self referral?
The purpose of diabetes care services-self referral is to allow individuals to conveniently access care and services for their diabetes without the need for a healthcare provider referral.
What information must be reported on diabetes care services-self referral?
Information such as personal details, diabetes diagnosis, and specific care needs must be reported on diabetes care services-self referral.
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