Get the free Palliative Care Common Referral Form (PC-CRF)

Palliative Care Common Referral Form (PC-CRF) Frequently Asked Questions The Palliative Care Common Referral Form (PC-CRF) has been in use by palliative care organizations across the City of Toronto

How to fill out palliative care common referral

How to fill out palliative care common referral:

1. Obtain the necessary referral form from the palliative care provider or the healthcare facility. This might be available online or in paper format.
2. Fill in the patient's personal information such as their full name, date of birth, address, and contact details. Ensure accuracy to facilitate communication.
3. Include the patient's medical history, diagnosis, and current condition. This information helps the palliative care team understand the patient's needs better.
4. Specify the reason for the referral and the goals of palliative care. This could include symptom management, pain relief, emotional support, or improving quality of life.
5. Indicate any relevant healthcare providers involved in the patient's care, including primary care physicians, specialists, or other healthcare professionals. Sharing this information ensures coordinated care.
6. Document any advanced care directives or end-of-life preferences expressed by the patient or their family. This helps guide the palliative care team in providing care that aligns with the patient's wishes.
7. Include any additional information or concerns that may be relevant to the referral. This could involve the patient's social support, financial considerations, or cultural preferences.

Who needs palliative care common referral:

1. Patients with a life-limiting illness or a serious medical condition that requires complex symptom management and support often benefit from a palliative care referral.
2. Individuals experiencing significant pain, discomfort, or distress associated with their medical condition may benefit from palliative care services.
3. Palliative care common referrals are appropriate for patients who require help with end-of-life planning, emotional support, and coordination of care across multiple healthcare providers.

Remember, each healthcare facility may have specific guidelines for completing a palliative care common referral form. It is important to follow any instructions provided and provide accurate information to facilitate seamless care for the patient.

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