Get the free CSHP Referral Form 2013 - Centre for Sleep and...

REFERRAL FORM Dr. Charles H. Samuel's, Medical Director Suite 106, 51 Sun park Drive, SE, Calgary, Alberta T2X 3V4 Tel (403) 254-6663 Fax (403) 254-6693 Email: patients centreforsleep.com (*Referrals

How to fill out cshp referral form 2013

How to Fill Out CSHP Referral Form 2013:

1. Begin by gathering all necessary information: Make sure you have the patient's full name, address, contact information, and date of birth. Also, gather any relevant medical records or documentation that may be required for the referral.
2. Start with the patient's information: Enter the patient's full name in the designated space on the form. Then, provide their current address and contact information, including phone number and email address, if applicable. Finally, write down the patient's date of birth accurately.
3. Specify the reason for the referral: In the appropriate section of the form, clearly state the purpose of the referral. This could be for a specific medical condition, consultation, or diagnostic testing. Be as descriptive as possible to ensure the recipient understands the nature of the referral.
4. Include relevant medical information: Briefly summarize the patient's medical history and any pertinent information regarding their condition that supports the need for the referral. This can include past diagnoses, treatments, medications, allergies, or any other relevant details.
5. Indicate the preferred specialist or facility: If the referring physician has a specific specialist or medical facility in mind, provide the name and contact information in the designated section of the form. If there are no preferences, leave this section blank.
6. Provide any additional documentation: If there are any specific documents or test results that need to be included with the referral, ensure they are attached to the form. This could include lab reports, imaging scans, or previous medical reports that are relevant to the referral.

Who Needs CSHP Referral Form 2013:

1. Patients requiring specialized medical care: The CSHP referral form 2013 is primarily meant for patients who need to be referred to specialists or medical facilities outside their primary healthcare provider's scope of care. This could include consultations with various specialists, diagnostic testing, or advanced treatments.
2. Physicians or healthcare providers: The form is necessary for healthcare professionals who need to refer their patients to specialists or medical facilities. These may include general practitioners, family physicians, or any other healthcare provider who requires specialized expertise for their patient's condition.
3. Insurance companies or healthcare networks: CSHP referral form 2013 may also be required by insurance companies or healthcare networks to ensure proper coordination of care and smooth referral processes. This helps in determining the medical necessity of the referral and facilitating communication between healthcare providers.

In summary, the CSHP referral form 2013 is used by healthcare providers to refer their patients to specialists or medical facilities for specialized care. It requires accurate patient information, a clear statement of the reason for referral, relevant medical history, and any additional documentation. This form is essential for proper communication and coordination between healthcare providers, patients, and insurance companies.

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What is cshp referral form?

cshp referral form is a document used to refer patients to the California Society of Health-System Pharmacists for further assistance.

Who is required to file cshp referral form?

Healthcare professionals such as pharmacists, physicians, and nurses are required to file cshp referral form.

How to fill out cshp referral form?

To fill out cshp referral form, you need to provide patient information, reason for referral, and contact information of the referring healthcare professional.

What is the purpose of cshp referral form?

The purpose of cshp referral form is to streamline the process of referring patients to the California Society of Health-System Pharmacists for specialized care and services.

What information must be reported on cshp referral form?

The information reported on cshp referral form includes patient demographics, medical history, reason for referral, and contact information of the referring healthcare professional.