Get the free Upper GI referral - Barts Health NHS Trust template

Suspected Upper Gastrointestinal Tract Cancers Referral FormPatient Details Surname:Date of Birth:Forename(s):Gender:Address (inc postcode):NHS Number:Telephone NumbersPlease check tel nos with patient

How to fill out upper gi referral

How to fill out upper gi referral form

1. Start by gathering all necessary information such as patient's demographics, medical history, and reason for referral.
2. Provide details on clinical presentation and symptoms that led to the decision for upper GI referral.
3. Specify any relevant diagnostic tests or procedures that have already been conducted.
4. Include any previous treatment and medications that the patient has tried.
5. Ensure that the referral form is signed and dated by the referring healthcare provider.

Who needs upper gi referral form?

1. Patients who are experiencing symptoms such as persistent abdominal pain, difficulty swallowing, unexplained weight loss, or gastrointestinal bleeding may need an upper GI referral form.
2. Healthcare providers, such as primary care physicians, gastroenterologists, or general surgeons, may also need to fill out an upper GI referral form for their patients.

What is Upper GI referral - Barts Health NHS Trust Form?

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Instructions for the form Upper GI referral - Barts Health NHS Trust

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What is upper gi referral form?

The upper gi referral form is a document used to refer patients for upper gastrointestinal procedures, such as endoscopies or specialized imaging services.

Who is required to file upper gi referral form?

Healthcare providers, such as physicians and specialists, are required to file the upper gi referral form when referring patients for upper gastrointestinal examinations.

How to fill out upper gi referral form?

To fill out the upper gi referral form, the healthcare provider must complete patient identification details, medical history, the reason for the referral, and any pertinent diagnostic information.

What is the purpose of upper gi referral form?

The purpose of the upper gi referral form is to facilitate the appropriate selection and scheduling of upper gastrointestinal procedures based on the patient's clinical needs.

What information must be reported on upper gi referral form?

The information that must be reported includes patient demographics, insurance information, medical history, the reason for referral, and relevant clinical findings.