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Referral Form: Rehabilitation / Readmission All fields to be completed before patients can be assessed for admission & PATIENTS MEDICATION CHART NEEDS TO BE INCLUDED WITH THIS Formulas Fax to Clinical
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How to fill out dph rehabilitation pre-admission referral
How to fill out dph rehabilitation pre-admission referral
01
Fill out the patient's personal information such as name, date of birth, address, and contact information.
02
Provide details about the patient's medical history, current diagnosis, and treatment plan.
03
Include information about the referring physician or healthcare provider.
04
Specify the reason for referral to DPH rehabilitation services.
05
Submit any relevant documentation such as medical records, test results, and insurance information.
Who needs dph rehabilitation pre-admission referral?
01
Patients who require rehabilitation services after a hospital stay, surgery, or injury.
02
Healthcare providers who are referring patients for specialized rehabilitation services.
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What is dph rehabilitation pre-admission referral?
The DPH rehabilitation pre-admission referral is a form that is submitted prior to a patient being admitted to a rehabilitation facility.
Who is required to file dph rehabilitation pre-admission referral?
Healthcare providers or facilities recommending a patient for rehabilitation are required to file the DPH rehabilitation pre-admission referral.
How to fill out dph rehabilitation pre-admission referral?
The DPH rehabilitation pre-admission referral can be filled out online or in paper form with the necessary patient information and provider recommendations.
What is the purpose of dph rehabilitation pre-admission referral?
The purpose of the DPH rehabilitation pre-admission referral is to ensure that patients are being properly recommended for and admitted to rehabilitation facilities.
What information must be reported on dph rehabilitation pre-admission referral?
The referral must include patient demographics, medical history, current condition, and the provider's rationale for recommending rehabilitation.
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