Get the free Diabetic Foot Ulcer Referral Form Grey Bruce Health Service 519-371-7695

Diabetic Foot Ulcer Referral Form Grey Bruce Health Services FAX: 5193717695 PHONE: 5193712121 ext 2876 Patient Details Name: Address:GP/NP: Billing Number:DOB:Fax #:Contact Number:Email:Please mark

How to fill out diabetic foot ulcer referral

How to fill out diabetic foot ulcer referral

1. To fill out a diabetic foot ulcer referral, follow these steps: 1. Gather patient information including name, age, contact information, and medical history.
2. Assess the severity of the foot ulcer and determine the appropriate referral
3. Include a detailed description of the foot ulcer, including size, depth, location, and any associated symptoms or complications
4. Mention any relevant medical interventions or treatments that have been tried and their outcomes
5. Provide a summary of the patient's current diabetic management and any additional relevant information
6. Include the name and contact information of the referring healthcare provider
7. Submit the referral to the appropriate healthcare facility or specialist for further evaluation and treatment

Who needs diabetic foot ulcer referral?

1. Patients with diabetic foot ulcers may need a referral for specialized care and treatment.
2. Individuals with diabetes who have foot ulcers that are slow to heal, infected, or have severe symptoms should be referred to a healthcare professional with expertise in diabetic foot care.
3. Patients with underlying conditions that may complicate the healing process, such as peripheral neuropathy or peripheral vascular disease, may also benefit from a diabetic foot ulcer referral.
4. It is important to rely on the expertise of healthcare professionals to determine if a referral is necessary based on the specific circumstances and severity of the diabetic foot ulcer.

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What is diabetic foot ulcer referral?

Diabetic foot ulcer referral is a process of referring a patient with a foot ulcer related to diabetes to a specialist for further evaluation and treatment.

Who is required to file diabetic foot ulcer referral?

Healthcare providers, such as primary care physicians or diabetes specialists, are required to file diabetic foot ulcer referral.

How to fill out diabetic foot ulcer referral?

Diabetic foot ulcer referral can be filled out by providing patient information, medical history, ulcer details, and reason for referral.

What is the purpose of diabetic foot ulcer referral?

The purpose of diabetic foot ulcer referral is to ensure timely and appropriate management of foot ulcers in diabetic patients to prevent complications.

What information must be reported on diabetic foot ulcer referral?

Information such as patient's name, contact information, medical history, ulcer size and location, and any previous treatments must be reported on diabetic foot ulcer referral.