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Paediatric Continence Service Referral FormAge 4 to 17 yearsPlease return by email to: epunft.paediatriccontinence@nhs.netPaediatric Continence Service The Old Pharmacy Rochford Hospital Union Lane
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How to fill out paediatric continence service referral

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How to fill out paediatric continence service referral

01
Start by gathering all the necessary information about the child, such as their demographic details, medical history, and previous treatments.
02
Contact the paediatric continence service provider to obtain the referral form.
03
Carefully read and understand the instructions on the referral form.
04
Enter the child's details accurately, including their full name, date of birth, and contact information.
05
Provide a detailed description of the child's continence issues, including any symptoms or associated conditions.
06
Include relevant medical reports, test results, or documentation that support the need for the referral.
07
List any medications or treatments the child is currently undergoing.
08
If applicable, mention any previous continence services the child has received.
09
Ensure that the referral is signed by the appropriate healthcare professional, such as a pediatrician or general practitioner.
10
Submit the completed referral form either in person, via mail, or through the electronic submission process as specified by the service provider.

Who needs paediatric continence service referral?

01
Children who experience continence issues such as bedwetting, daytime wetting, or constipation.
02
Children with neurogenic bladder or bowel conditions.
03
Children with congenital or acquired abnormalities of the urinary or digestive system.
04
Children who have undergone surgery or medical treatments that may affect continence.
05
Children with developmental disorders or disabilities that impact continence.
06
Children who have not responded to previous conservative treatments and require specialized professional intervention.
07
Children whose parents or caregivers have concerns about their continence and seek professional guidance.

What is Paediatric Continence Service Referral Age 4 to 17 ... Form?

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Paediatric continence service referral is a process by which healthcare professionals refer children experiencing bladder or bowel control issues to specialized continence services for assessment and management.
Generally, healthcare professionals such as pediatricians, family doctors, or allied health providers are required to file paediatric continence service referrals.
To fill out a paediatric continence service referral, one should complete the designated referral form with patient information, describe the patient's symptoms, medical history, and any relevant assessments, and include contact details for follow-up.
The purpose of paediatric continence service referral is to provide children with the necessary evaluation and intervention for their continence issues, aimed at improving their quality of life.
Information that must be reported includes the child's demographics, medical history, nature of the continence issues, previous treatments, and any relevant family history.
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