Get the free Falls Assessment Clinic referral form - Healthfirst Network - healthfirst org

Central Adelaide Local Health Networks Falls Assessment Clinic referral form To Falls Assessment Clinic Fax No 1300 724 900 From No of pages (Including this page and medical summary) Organization

How to fill out falls assessment clinic referral

How to fill out falls assessment clinic referral:

1. Obtain the referral form from the falls assessment clinic or website.
2. Begin by filling out the patient's personal information such as name, date of birth, and contact details.
3. Provide the patient's medical history, including any previous falls, injuries, or relevant medical conditions.
4. Indicate the reason for referral, describing the patient's current concerns or symptoms related to falls.
5. Include any relevant medications the patient is currently taking, as well as any known allergies.
6. Provide information about the patient's primary care physician or referring healthcare professional, including their contact information.
7. If available, attach any relevant medical documents or test results that may support the referral.
8. Sign and date the referral form to validate the information provided.

Who needs falls assessment clinic referral:

1. Patients who have experienced one or multiple falls recently and are concerned about their risk of falling again.
2. Individuals with a history of falls or balance issues, especially if they have suffered injuries as a result.
3. Older adults or seniors who may have age-related changes or medical conditions that increase their risk of falling.
4. Patients with specific medical conditions or taking medications that can affect balance and coordination.
5. Individuals who have undergone recent surgeries or are in post-acute care, as their mobility and balance may be compromised.
6. People with neurological disorders or musculoskeletal conditions that may impact their balance and mobility.
7. Individuals who have experienced changes in their vision or sensory perception that may contribute to their risk of falling.

For pdfFiller’s FAQs

What is falls assessment clinic referral?

Falls assessment clinic referral is a process where a patient is referred to a specialized clinic to assess and address the risk factors contributing to falls.

Who is required to file falls assessment clinic referral?

Healthcare professionals such as doctors, nurses, and therapists are required to file falls assessment clinic referral for patients who are at risk of falling.

How to fill out falls assessment clinic referral?

Falls assessment clinic referral can be filled out by providing relevant patient information, medical history, current medications, and description of fall incidents.

What is the purpose of falls assessment clinic referral?

The purpose of falls assessment clinic referral is to identify and address the underlying causes of falls in order to prevent future incidents and improve patient safety.

What information must be reported on falls assessment clinic referral?

Information such as patient demographics, medical history, current medications, previous fall incidents, and any relevant test results must be reported on falls assessment clinic referral.

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