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Internal useBreast Assessment Referral IMMEDIATE RESPONSE REQUIREDABNORMAL BREAST IMAGING REPORT To:From: Breast ClinicRecipient Fax:Sender Fax: 4162843116Recipients Phone:Senders Phone: 4162848131
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How to fill out breast assessment referral
How to fill out breast assessment referral
01
To fill out a breast assessment referral, follow the steps below:
02
Begin by obtaining the necessary referral form from the healthcare provider or clinic.
03
Fill out the basic patient information, such as name, date of birth, and contact details.
04
Provide relevant medical history, including any previous breast conditions, surgeries, or family history of breast cancer.
05
Indicate the reason for referral, such as abnormal mammogram findings, presence of breast lumps, or other concerning symptoms.
06
Include any other relevant information, such as additional diagnostic tests already performed or relevant medical reports.
07
Ensure the referral is signed and dated by the referring healthcare provider.
08
Submit the completed referral form to the designated breast assessment center or healthcare facility.
09
Follow any additional instructions provided by the healthcare facility regarding appointment scheduling or further steps to be taken.
10
It is important to fill out the referral accurately and completely to ensure appropriate assessment and timely intervention if required.
Who needs breast assessment referral?
01
A breast assessment referral is typically needed for individuals who require further evaluation of breast abnormalities or symptoms.
02
This may include individuals who have:
03
- Discovered breast lumps or other suspicious breast changes
04
- Experienced breast pain or discomfort
05
- Received abnormal results from a mammogram or other breast imaging tests
06
- A family history of breast cancer
07
- Previous breast conditions or surgeries
08
It is important to consult with a healthcare provider to determine if a breast assessment referral is necessary based on individual circumstances.
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What is breast assessment referral?
Breast assessment referral is a formal request for evaluation of breast conditions or abnormalities, typically initiated by a primary care provider to ensure timely diagnosis and treatment.
Who is required to file breast assessment referral?
Healthcare providers, specifically physicians or nurse practitioners who suspect a breast condition that requires further examination, are required to file a breast assessment referral.
How to fill out breast assessment referral?
Filling out a breast assessment referral typically involves completing a standardized form that includes patient identification information, clinical findings, and specific concerns that warrant further assessment by a specialist.
What is the purpose of breast assessment referral?
The purpose of a breast assessment referral is to facilitate prompt and accurate diagnosis of breast issues, guiding the patient to appropriate care and treatment options.
What information must be reported on breast assessment referral?
Required information on a breast assessment referral includes patient demographics, medical history, details of the breast examination or imaging results, and the reason for the referral.
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