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Counselling and Bereavement Service Referral Form For people (16+) in need of BEREAVEMENT SUPPORT OR ACCREDITED COUNSELLING (AQP) via accredited APT Trained counselors Patient Name: NHS No. Mr/Mrs/Ms
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Start by gathering all necessary personal information, such as full name, address, date of birth, and contact details.
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Next, provide relevant medical information, including any known diagnoses, current medications, and previous treatments.
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Indicate the reason for seeking hospice care and any specific needs or preferences.
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Specify any advance care directives or legal documents related to the patient's healthcare decisions.
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Provide insurance details, including policy numbers and contact information.
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Who needs here - peace hospice:
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Individuals with a life-limiting illness or terminal condition who require specialized medical care, emotional support, and pain management.
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Patients who prefer to receive end-of-life care in a comfortable and compassionate environment, surrounded by a multidisciplinary team of healthcare professionals.
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Families and loved ones of patients who need assistance and guidance in navigating the complex medical, emotional, and practical aspects of end-of-life care.
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Healthcare providers and professionals involved in the patient's care, seeking to facilitate a smooth and coordinated transition to peace hospice for their patients.
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What is here - peace hospice?
Peace Hospice is a place where individuals can receive palliative care and support during their end-of-life journey.
Who is required to file here - peace hospice?
Staff members, volunteers, and healthcare providers who work at Peace Hospice are required to file certain documentation and reports.
How to fill out here - peace hospice?
The forms and reports required to be filled out at Peace Hospice can be completed either electronically or on paper, following the provided guidelines.
What is the purpose of here - peace hospice?
The purpose of Peace Hospice is to provide compassionate care, pain management, and support to individuals who are terminally ill.
What information must be reported on here - peace hospice?
Information such as patient demographics, medical history, treatment plans, and progress notes must be reported on the forms at Peace Hospice.
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