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4626 Poplar Ave. Memphis, TN 38117 9013174414 (office) Please email form back to eastmemphispethospital@gmail.comHeather Prospered, DVM, CVA, CORP Client name: Phone number: Email address: Pet Name: Breed: Date
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How to fill out rehab consult form

01
Start by gathering all necessary information about the patient, including their medical history, current symptoms, and any relevant test results.
02
Fill out the patient's demographics, including their name, age, gender, and contact information.
03
Document the reason for the referral for rehab consultation and any specific goals or concerns for the patient.
04
Provide details about the patient's functional status, including their ability to perform daily activities and any mobility or strength limitations.
05
Include any relevant medical history, such as past surgeries, injuries, or chronic conditions that may impact the rehab consultation.
06
Specify any medications the patient is currently taking and any known allergies or intolerances.
07
Collaborate with the rehab team to develop a comprehensive plan of care for the patient and ensure all necessary documentation is completed accurately.

Who needs rehab consult form?

01
Patients who require rehabilitation services after an illness, injury, or surgery.
02
Healthcare providers who are referring patients for specialized rehab services.
03
Insurance companies or other payers who need documentation of the rehab consultation for reimbursement purposes.
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Rehab consult form is a document used to assess and evaluate a person's medical condition, treatment plan, and rehabilitation needs.
Healthcare providers, physicians, and therapists are required to file the rehab consult form.
The rehab consult form can be filled out by providing detailed information about the patient's current condition, treatment history, and rehabilitation goals.
The purpose of the rehab consult form is to create a comprehensive plan for the patient's rehabilitation and recovery.
Information such as medical history, current medications, treatment progress, and recommended rehabilitation therapies must be reported on the rehab consult form.
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