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Bendigo Health Pediatric Speech Pathology and
Audiology Referral Form
Date of referral/s Click here to enter a date.
Referral/s required(Please tick)Speech Pathology Community Health OutpatientsSpeech
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How to fill out speech pathology paediatric referral

How to fill out speech pathology paediatric referral
01
To fill out a speech pathology paediatric referral, follow these steps:
02
Start by gathering all the necessary information about the patient, such as their personal details, medical history, and any relevant test results.
03
In the referral form, provide the patient's full name, date of birth, address, and contact information.
04
Specify the reason for the referral, such as the child's communication difficulties, speech delays, or language disorders.
05
Include any additional information about the child's condition, such as associated symptoms or related medical conditions.
06
Provide details about the referring healthcare professional, including their name, contact information, and professional credentials.
07
Indicate whether the child has received any previous speech pathology services or assessments.
08
If applicable, provide any relevant test results or reports that support the need for speech pathology services.
09
Finally, sign and date the referral form before submitting it to the appropriate speech pathology clinic or professional.
Who needs speech pathology paediatric referral?
01
Speech pathology paediatric referral is needed by children who are experiencing communication difficulties, speech delays, language disorders, or any other related issues. It is typically requested by healthcare professionals, such as pediatricians, family doctors, or psychologists, who have identified the need for further assessment and intervention in the child's speech and language development. The referral helps connect the child and their family with a speech pathology specialist who can provide appropriate evaluation, therapy, and support.
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What is speech pathology paediatric referral?
Speech pathology paediatric referral is the process of recommending a child to a speech pathologist for assessment and treatment of communication or swallowing disorders.
Who is required to file speech pathology paediatric referral?
Typically, health care professionals such as pediatricians, teachers, or psychologists are required to file a speech pathology paediatric referral.
How to fill out speech pathology paediatric referral?
To fill out a speech pathology paediatric referral, provide the child's personal information, describe specific concerns regarding their speech or language abilities, and include any relevant medical or educational history.
What is the purpose of speech pathology paediatric referral?
The purpose of speech pathology paediatric referral is to ensure that children who exhibit speech, language, or swallowing difficulties receive appropriate assessment and intervention.
What information must be reported on speech pathology paediatric referral?
The referral must include the child's full name, date of birth, reason for referral, specific areas of concern, and any previous assessments or interventions.
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