
Get the free Weight Management Patient Referral Form
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SMC PhysiciansEndocrinology, Diabetes &
Weight Management
Samar Brushed, MD
Padua Venkataraman, MD
Hammed Malik, APN
Lizzie Fowler, GNP
Alison Strittmatter, Kidney & Hypertension
Tamil Saber, MD,
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How to fill out weight management patient referral

How to fill out weight management patient referral
01
Obtain necessary patient information including name, contact information, date of birth, medical history, and current medications.
02
Assess patient's body mass index (BMI) to determine if they meet criteria for weight management referral.
03
Discuss weight management options with the patient and provide education on healthy lifestyle choices.
04
Complete the weight management patient referral form with all relevant information and submit it to the appropriate department for further evaluation and scheduling.
05
Follow up with the patient to ensure they have successfully received the referral and are actively engaged in weight management programs.
Who needs weight management patient referral?
01
Patients who are struggling with obesity or overweight and are in need of professional assistance to manage their weight.
02
Healthcare providers who believe their patients would benefit from weight management programs and want to help them achieve their health goals.
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What is weight management patient referral?
Weight management patient referral is a process where healthcare providers refer a patient to a specialized weight management program or health professional to help them manage their weight.
Who is required to file weight management patient referral?
Healthcare providers, such as doctors, nurses, or dietitians, are required to file weight management patient referral for patients who may benefit from weight management services.
How to fill out weight management patient referral?
To fill out weight management patient referral, healthcare providers need to collect relevant patient information, assess the patient's weight management needs, and refer them to appropriate programs or professionals.
What is the purpose of weight management patient referral?
The purpose of weight management patient referral is to provide patients with access to specialized weight management services that can help them achieve and maintain a healthy weight.
What information must be reported on weight management patient referral?
Weight management patient referral should include patient demographics, medical history, current weight status, weight management goals, and any relevant clinical information.
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