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Erie St. Clair and SW Ontario Cataract Central Intake Referral Form Cataract Central Intake Fax Number: 5196466368 Telephone Number: 5196466100 ext.61680 Email: SJHCCataractCentralIntake@sjhc.london.on.ca**

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How to fill out cataract central intake referral

01

Obtain the cataract central intake referral form from the appropriate healthcare provider or facility.

02

Fill out the patient's personal information including name, date of birth, address, and contact information.

03

Provide details about the patient's medical history and any relevant eye conditions.

04

Include information about the patient's current eye symptoms and the severity of their cataracts.

05

Indicate any urgency for the referral and if there are specific preferences for the ophthalmologist or treatment facility.

06

Submit the completed referral form to the designated central intake office according to the instructions provided.

Who needs cataract central intake referral?

01

Individuals diagnosed with cataracts who require evaluation and treatment by an ophthalmologist.

02

Patients experiencing symptoms such as blurry vision, difficulty seeing at night, or seeing halos around lights due to cataracts.

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What is cataract central intake referral?

Cataract central intake referral is a process where patients are referred to a central intake system for cataract surgery.

Who is required to file cataract central intake referral?

Ophthalmologists and optometrists are required to file cataract central intake referral for their patients.

How to fill out cataract central intake referral?

Cataract central intake referral can be filled out online through the central intake system or through paper forms provided by the central intake office.

What is the purpose of cataract central intake referral?

The purpose of cataract central intake referral is to streamline the process of scheduling cataract surgeries and ensure timely access to care for patients.

What information must be reported on cataract central intake referral?

Cataract central intake referral must include patient demographics, medical history, current medications, and eye exam findings.

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