Get the free stroke prevention clinic referral form

Patient ID Label Name: ___ DOB: ___ Contact Info: ___ Best Phone Number to Reach Patient: ___ Email Address: ___Stroke Prevention Clinic Contact 201 Georgian Drive, Barrie, ON Phone: 7057289090 Ext.

How to fill out stroke prevention clinic referral

How to fill out stroke prevention clinic referral

1. Obtain the referral form from the stroke prevention clinic.
2. Fill out the patient's personal information including name, date of birth, address, and contact information.
3. Provide relevant medical history information such as previous strokes, medications, and other health conditions.
4. Include any relevant test results or imaging studies that may assist in the patient's diagnosis and treatment plan.
5. Sign and date the referral form before submitting it to the stroke prevention clinic.

Who needs stroke prevention clinic referral?

1. Patients who have a history of stroke or are at risk of having a stroke may need a stroke prevention clinic referral.
2. Individuals who have risk factors for stroke such as high blood pressure, diabetes, or heart disease may also benefit from a referral to a stroke prevention clinic.

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What is stroke prevention clinic referral?

Stroke prevention clinic referral is a process where individuals who are at risk of stroke are referred to specialized clinics for assessment, treatment, and monitoring to prevent the occurrence of stroke.

Who is required to file stroke prevention clinic referral?

Healthcare professionals such as doctors, nurses, or specialists are required to file stroke prevention clinic referral for patients who are at risk of stroke.

How to fill out stroke prevention clinic referral?

Fill out the referral form with the patient's information, medical history, risk factors, and reason for referral. Submit the form to the designated clinic for review.

What is the purpose of stroke prevention clinic referral?

The purpose of stroke prevention clinic referral is to identify individuals at risk of stroke, provide appropriate interventions to reduce the risk, and prevent the occurrence of stroke.

What information must be reported on stroke prevention clinic referral?

Information such as patient demographics, medical history, risk factors for stroke, current medications, and reason for referral must be reported on stroke prevention clinic referral.