Get the free GCPHN Persistent Pain Program Referral Form 20152016

Gold Coast Primary Health Network (ICAHN) Persistent Pain Program Returning Officer: Joyce McEwan Mobile 0412 327 795 Please Fax to: 07 5635 2466 ICAHN Persistent Pain Program Referral Form 2015/2016

How to fill out gcphn persistent pain program

How to fill out gcphn persistent pain program:

1. Start by accessing the gcphn persistent pain program forms online or through your healthcare provider.
2. Review the instructions and gather all the necessary information and documents required to fill out the program.
3. Begin by entering your personal information accurately, including your full name, address, contact details, and any relevant medical history.
4. Follow the provided prompts and questions on the form to provide details about your persistent pain condition, including its duration, severity, and any previous treatments or interventions you have tried.
5. Make sure to provide a thorough description of your pain symptoms, including any triggers or patterns you have noticed.
6. If applicable, provide information about any healthcare professionals you have consulted for your pain condition, including their names, contact information, and the dates of your visits.
7. If you are currently taking any medications for pain management, provide the names, dosages, and frequencies.
8. Answer all additional questions or sections on the form as accurately and comprehensively as possible.
9. Once you have completed the form, review it carefully to ensure all information is correct and complete.
10. If applicable, consult with your healthcare provider or any other professionals involved in your care to ensure the accuracy of your responses.
11. Finally, submit the completed gcphn persistent pain program form according to the provided instructions, whether it is through an online submission or by returning the form to your healthcare provider.

Who needs gcphn persistent pain program:

1. Individuals who are experiencing persistent pain that has lasted for more than three months.
2. Those who have tried various treatments or interventions for their pain but have not found significant relief.
3. Individuals who are seeking additional support, resources, and guidance for managing their persistent pain condition.
4. Patients who would benefit from a multidisciplinary approach to pain management, which may involve various healthcare professionals collaborating to develop a personalized treatment plan.
5. People who are motivated to actively participate in their pain management and are willing to commit to the program's requirements, such as attending appointments and implementing recommended strategies.
6. Patients who reside within the area covered by gcphn and are eligible for their services.
7. Individuals who have been referred to the gcphn persistent pain program by their healthcare provider or have independently sought out the program for assistance.

For pdfFiller’s FAQs

What is gcphn persistent pain program?

The gcphn persistent pain program is a program designed to help individuals manage and cope with persistent pain.

Who is required to file gcphn persistent pain program?

Individuals who are experiencing persistent pain and seeking support are required to participate in the gcphn persistent pain program.

How to fill out gcphn persistent pain program?

To fill out the gcphn persistent pain program, individuals can contact their healthcare provider or the program administration for guidance and assistance.

What is the purpose of gcphn persistent pain program?

The purpose of the gcphn persistent pain program is to provide resources, support, and education to help individuals better manage their persistent pain.

What information must be reported on gcphn persistent pain program?

The gcphn persistent pain program may require individuals to report their pain levels, treatment plans, progress, and any challenges they may be experiencing.

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