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CENTRAL SITE North York General Hospital Branson Site 555 Finch Avenue West, Toronto, Ontario M2R 1N5 TEL 416-635-2415 FAX 416-635-2427 x SATELLITE SITE Markham Stoneville Hospital 381 Church Street,
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How to fill out referralform-hipknee-rev5-sept 09doc
How to fill out referralform-hipknee-rev5-sept 09doc:
01
Start by entering your personal information in the designated fields. This includes your name, address, contact number, and email address.
02
Move on to the section where you need to provide information about your hip or knee condition. Specify the nature of your condition, any previous treatments you have undergone, and any relevant medical history.
03
Next, indicate your preferred healthcare provider or medical specialist for further evaluation or treatment.
04
If you have any specific concerns or additional information regarding your condition, make sure to include them in the appropriate section.
05
Finally, review the completed referral form to ensure all the information provided is accurate and clear. Sign and date the form before submitting it to the appropriate recipient.
Who needs referralform-hipknee-rev5-sept 09doc:
01
Patients experiencing hip or knee problems who are seeking further evaluation or treatment.
02
Individuals who have been recommended by their primary care physician or another healthcare professional to consult with a hip or knee specialist.
03
Patients who want to request a referral from their insurance provider for coverage of hip or knee related medical services.
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