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HEALTH SCIENCES NORTH (HAN) STROKE PREVENTION (TIA) CLINIC REFERRAL FORM
PATIENT ___ PHONE N O. TO REACH P PATIENT___
REFERRING PHYSICIAN ___F FAMILY PHYSICIAN ___REFERRING PHYSICIAN SIGNATURE ___
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How to fill out stroke prevention clinic
How to fill out stroke prevention clinic
01
Contact the stroke prevention clinic to schedule an appointment.
02
Bring any relevant medical records or information with you to the appointment.
03
Be prepared to discuss your medical history, any risk factors for stroke, and any symptoms you may be experiencing.
04
Follow any recommendations or treatment plans provided by the clinic to help prevent strokes in the future.
Who needs stroke prevention clinic?
01
Individuals who have already experienced a stroke and want to prevent future episodes.
02
People who have risk factors for stroke, such as high blood pressure, diabetes, or a family history of stroke.
03
Individuals who are interested in learning more about stroke prevention and how to reduce their risk.
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What is stroke prevention clinic?
A stroke prevention clinic is a medical facility dedicated to assessing and managing risk factors for stroke in individuals.
Who is required to file stroke prevention clinic?
Healthcare professionals and medical facilities offering stroke prevention services are required to file stroke prevention clinic reports.
How to fill out stroke prevention clinic?
The stroke prevention clinic report must be filled out with detailed information on patient assessments, risk factors, treatments, and follow-up plans.
What is the purpose of stroke prevention clinic?
The purpose of a stroke prevention clinic is to identify individuals at risk for stroke, provide interventions to reduce that risk, and monitor their progress over time.
What information must be reported on stroke prevention clinic?
Information such as patient demographics, risk factors, assessment results, treatment plans, and follow-up recommendations must be reported on the stroke prevention clinic.
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