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BARTLETT REGIONAL HOSPITAL OUTPATIENT PULMONARY REHABILITATION REFERRAL ORDERS Patient Name: ___ DOB: ___ Address: ___ City: ___ Zip: ___ Phone: ___Diagnosis: ___1. Please enroll in Pulmonary Rehabilitation
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How to fill out regional pulmonary rehab referral

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How to fill out regional pulmonary rehab referral

01
Start by obtaining the referral form from the regional pulmonary rehab program.
02
Fill out the patient's personal information including name, contact details, and date of birth.
03
Provide the medical history of the patient including any relevant diagnoses, current medications, and previous treatments.
04
Include the reason for the referral and any specific goals or objectives for the patient's rehab program.
05
Obtain any necessary signatures from the referring physician or healthcare provider.
06
Submit the completed referral form to the regional pulmonary rehab program for review and processing.

Who needs regional pulmonary rehab referral?

01
Individuals with chronic respiratory conditions such as COPD, asthma, or pulmonary fibrosis may benefit from a regional pulmonary rehab referral.
02
Patients who have recently undergone lung surgery or transplantation may also require a referral for specialized rehab services.
03
People with a history of frequent respiratory infections or hospitalizations due to lung-related issues may benefit from a structured pulmonary rehab program.
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A regional pulmonary rehab referral is a formal request for a patient to participate in a pulmonary rehabilitation program, which is aimed at improving the physical and emotional well-being of individuals with chronic respiratory diseases.
Typically, healthcare providers such as physicians or specialists who manage patients with chronic respiratory conditions are required to file regional pulmonary rehab referrals.
To fill out a regional pulmonary rehab referral, you typically need to provide patient details, medical history, specific diagnoses related to pulmonary issues, and any relevant treatment plans. The form must be completed accurately and signed by the responsible healthcare provider.
The purpose of a regional pulmonary rehab referral is to ensure that patients with chronic lung diseases receive coordinated care and access to rehabilitation programs that can enhance their quality of life and functional capabilities.
The information that must be reported on a regional pulmonary rehab referral includes patient identification details, diagnosis codes, treatment history, current medications, and any other relevant clinical information necessary for the rehabilitation team.
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