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CONFIDENTIAL Enteral Feeding Community Dietetic ReferralCOMMUNITY NUTRITION AND DIETETIC SERVICE Please complete shaded areas on BOTH sides with essential information in BLOCK CAPITALS. If eregistration
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How to fill out community-enteral-referral- template

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How to fill out community-enteral-referral-form

01
Gather all the necessary information about the patient and their condition.
02
Download the community-enteral-referral-form from the official website or obtain a physical copy.
03
Fill out the patient's personal details accurately, including their full name, contact information, and date of birth.
04
Provide information about the patient's medical history, current medications, and any allergies or dietary restrictions.
05
Include details about the patient's diagnosis, treatment plan, and the need for enteral nutrition.
06
Indicate the duration for which enteral nutrition is required.
07
If applicable, specify any specialized equipment or supplies needed for enteral feeding.
08
Include the name and contact information of the referring healthcare professional.
09
Sign and date the referral form to validate the information provided.
10
Submit the completed community-enteral-referral-form to the appropriate healthcare facility or organization.

Who needs community-enteral-referral-form?

01
Patients who are unable to meet their nutritional needs orally or via normal food intake.
02
Individuals with medical conditions such as severe malnutrition, swallowing difficulties, or gastrointestinal disorders.
03
Patients who require long-term enteral nutrition support.
04
Individuals undergoing medical treatments or recovering from surgery that affect their ability to consume regular food.
05
People with disabilities or impairments that hinder their ability to feed themselves.
06
Patients who have experienced weight loss or have a body mass index indicating undernourishment.
07
Individuals with chronic illnesses or those undergoing palliative care.

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The community-enteral-referral-form is a document used to facilitate the referral process for patients requiring enteral nutrition services within a community healthcare setting.
Healthcare providers, including physicians and nutritionists, who are referring patients for enteral nutrition services are required to file the community-enteral-referral-form.
To fill out the community-enteral-referral-form, providers should accurately complete all sections, including patient information, medical history, nutritional needs, and caregiver details, ensuring all data is current and complete.
The purpose of the community-enteral-referral-form is to standardize the referral process for enteral nutrition services, ensuring that patients receive appropriate care and resources efficiently.
The information that must be reported includes patient demographics, diagnosis, details of enteral nutrition requirements, healthcare provider information, and any additional notes regarding the patient's condition.
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