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REFERRAL SLIP ACT ENDODONTICS, LLC Ronald Taylor DDS, MSD Adam Oriel DDS, MS Bad Parading DDS, MS Judson Sung DDS, Machine Boston DDS, MS Tierney Weinberg DDS, MS Alexis Herring DDS Eunice Kim Referring
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How to fill out referral slip

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How to fill out referral slip

01
Obtain a referral slip from your primary care physician.
02
Fill out your personal information such as name, date of birth, and contact information.
03
Provide details about the specialist or facility you are being referred to.
04
Have your primary care physician sign and date the referral slip before submitting it.

Who needs referral slip?

01
Patients who require specialized medical care from a specialist or facility that requires a referral from their primary care physician.
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A referral slip is a form or document used to refer a patient to another healthcare provider or specialist for further evaluation or treatment.
Healthcare providers such as doctors, physicians, or nurse practitioners are required to file referral slips when referring a patient to another provider.
To fill out a referral slip, healthcare providers need to include the patient's information, reason for the referral, any relevant medical history, and contact information for the receiving provider.
The purpose of a referral slip is to ensure that patients receive the appropriate care and treatment from specialists or other healthcare providers when needed.
Information such as patient demographics, reason for referral, medical history, and contact information for both the referring and receiving provider must be reported on a referral slip.
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