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Hip and Knee Replacement Referral Please print, complete and return this form by fax to the appropriate clinic below. Attach the following with the completed form Relevant medical history/EMR Record
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How to fill out hip and knee replacement

01
Consult with your healthcare provider to discuss symptoms and options.
02
Undergo diagnostic imaging (X-rays, MRI) to assess joint damage.
03
Explore non-surgical treatments such as medications, physical therapy, and injections.
04
If surgery is deemed necessary, schedule the procedure with an orthopedic surgeon.
05
Prepare for surgery by following pre-operative instructions from your doctor.
06
Undergo the hip or knee replacement surgery.
07
Follow post-operative care instructions for recovery.
08
Attend follow-up appointments to monitor healing and regain mobility.

Who needs hip and knee replacement?

01
Individuals suffering from severe arthritis or joint pain.
02
Patients with hip or knee joint deformities.
03
People experiencing limited mobility due to chronic pain.
04
Individuals who have not found relief from non-surgical treatments.
05
Patients with significant joint damage from injury or wear and tear.
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Hip and knee replacement are surgical procedures that involve removing damaged joints and replacing them with artificial implants to relieve pain and restore function.
Patients undergoing hip and knee replacement surgeries are typically required to file necessary medical forms and insurance claims to secure coverage for the procedure.
Filling out hip and knee replacement forms usually involves providing personal information, medical history, details about the condition being treated, and information about the surgical procedure.
The purpose of hip and knee replacement is to alleviate pain, improve mobility, and enhance the quality of life for individuals experiencing severe joint damage or arthritis.
Information reported on hip and knee replacement may include patient demographics, diagnosis, surgical details, pre-operative assessments, and post-operative outcomes.
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