Get the free Outpatient Rehab referral notepads v2.indd

Outpatient Rehabilitation Services evergreen health.com12039 NE 128th Street, Suite 200 Kirkland, WA 98034 Date: Patient: DOB: Diagnosis: Frequency/Duration: Neurological Rehabilitation: 425.899.3100

How to fill out outpatient rehab referral notepads

How to fill out outpatient rehab referral notepads

1. Start by writing the date on the top of the referral notepad.
2. Fill in the patient's name, address, and contact information in the designated fields.
3. Provide relevant medical information such as the patient's diagnosis, medical history, and current medications.
4. Indicate the reason for the referral and specify the type of outpatient rehab needed.
5. Include any additional information or special instructions that may be necessary for the outpatient rehab provider.
6. Sign and date the referral notepad as the referring healthcare professional.
7. Make a copy of the referral for your records if needed.
8. Give the completed referral notepad to the patient or their designated representative.
9. Ensure that the referral notepad reaches the appropriate outpatient rehab provider in a timely manner.
10. Follow up with the patient and outpatient rehab provider as necessary to ensure continuity of care.

Who needs outpatient rehab referral notepads?

1. Outpatient rehab referral notepads are needed by healthcare professionals, such as doctors, therapists, or social workers, who are referring patients to outpatient rehab services.
2. These notepads are also required by outpatient rehab providers who receive referrals and need a standardized form to document and track the referral information.

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What is outpatient rehab referral notepads?

Outpatient rehab referral notepads are specialized forms used to refer individuals to outpatient rehabilitation services.

Who is required to file outpatient rehab referral notepads?

Healthcare providers, physicians, or therapists who are referring patients to outpatient rehab services are required to file the referral notepads.

How to fill out outpatient rehab referral notepads?

Outpatient rehab referral notepads can be filled out by providing patient information, reasons for referral, recommended treatment plan, and any other relevant details.

What is the purpose of outpatient rehab referral notepads?

The purpose of outpatient rehab referral notepads is to ensure a smooth transition for patients from hospital care to outpatient rehabilitation services.

What information must be reported on outpatient rehab referral notepads?

Patient demographics, medical history, diagnosis, treatment goals, and referring provider information must be reported on outpatient rehab referral notepads.