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FAMILY NAMEMRNGIVEN NAME MALE FEMALES. O.B. ___/___/___Facility: Calvary Health Care KogarahADDRESSRESIDENTIAL AGED CARE: PALLIATIVE CARE REFERRALLOCATION / WARM. O.COMPLETE ALL DETAILS OR AFFIX PATIENT
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Obtain a copy of the residential-aged-care-palliative-care-referral-formpdf
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Fill out the patient's personal information including name, address, date of birth, and contact information
03
Provide details about the patient's medical history and current health status
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Specify the reason for referring the patient to residential aged care palliative care
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Include any additional information or documentation that may be relevant to the referral
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Doctors, healthcare professionals, or caregivers who are referring a patient to residential aged care palliative care
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Residential-aged-care-palliative-care-referral-form.pdf is a form used to refer individuals in residential aged care to palliative care services.
Healthcare providers or aged care facility staff members are required to file the form.
The form should be filled out with detailed information about the patient's condition and care needs, and then submitted to the appropriate palliative care service provider.
The purpose of the form is to facilitate the referral of individuals in residential aged care to palliative care services in order to ensure they receive appropriate end-of-life care.
Information such as the patient's medical history, current condition, pain management needs, and preferences for care should be reported on the form.
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