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Patient Labels form is accessible on www.royalpapworth.nhs.ukIntensive Care UnitEXTRACORPOREAL MEMBRANE OXYGENATION (ECHO) REFERRAL FORM Please always phone Pap worth ECHO Coordinator (01223 638000),
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01
Download the ecmo-referral-form-v37pdf from the provided source.
02
Fill in the required patient information such as name, age, date of birth, and medical history.
03
Complete the sections related to the reason for ECMO referral, current condition of the patient, and any additional relevant details.
04
Obtain necessary signatures from healthcare providers and other parties involved in the referral process.
05
Ensure all sections are filled out accurately and legibly before submitting the form for review.

Who needs ecmo-referral-form-v37pdf?

01
Healthcare providers who are considering ECMO as a treatment option for a critically ill patient.
02
Medical facilities that require a standardized referral form for ECMO services.
03
Patients or their caregivers who have been advised to consider ECMO therapy by their healthcare team.
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ECMO-referral-form-v37pdf is a referral form used for requesting ECMO (Extracorporeal Membrane Oxygenation) services for patients.
Medical professionals such as doctors, surgeons, and healthcare providers are required to file the ecmo-referral-form-v37pdf.
The ecmo-referral-form-v37pdf should be filled out with accurate patient information, medical history, reason for ECMO referral, and any other relevant details.
The purpose of ecmo-referral-form-v37pdf is to facilitate the referral process for ECMO services and ensure that patients receive timely and appropriate care.
The ecmo-referral-form-v37pdf should include patient demographics, medical history, current condition, reason for referral, and any other relevant clinical information.
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