Get Vancouver Island Multiple Sclerosis Clinic Referral Form
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How to fill out the VANCOUVER ISLAND MULTIPLE SCLEROSIS CLINIC REFERRAL FORM online
Filling out the Vancouver Island Multiple Sclerosis Clinic Referral Form online is a crucial step in accessing the necessary care and support for individuals diagnosed with multiple sclerosis. This guide provides clear and detailed instructions to help you navigate each section of the form confidently.
Follow the steps to complete the form effectively
- Click the ‘Get Form’ button to access the form and open it in your preferred editor.
- Begin by entering the patient's name, including last and first names, and indicate their gender. Fill in the patient's address and BC Health Card number along with the date of birth and phone numbers.
- Provide information regarding the patient's home living situation. Indicate if the patient is currently employed, specify if they live alone or with others, and note their occupation and primary language spoken.
- Confirm the diagnosis of multiple sclerosis by selecting the type of disease course and noting the date of onset. Categorize the patient's current condition according to the provided descriptions.
- Specify the reason for the consult by indicating any problems or special therapies required, using the space provided for details.
- List the patient's medications and any known allergies.
- Indicate whether the patient has a neurologist in the community and provide their name if applicable. Note if the patient has been seen at the MS clinic in the past six months.
- Select a preferred neurologist from the options or choose 'First Available.' Provide previous diagnostic results and attach relevant reports.
- Detail any prior neurological consultations as requested.
- Finally, fill out the name, address, phone, and fax number of the family doctor.
- Review all entered information for accuracy. After ensuring completeness, save the changes, and download, print, or share the form as needed.
Complete your referral form online today to ensure timely access to the necessary medical services.
Receiving a timely referral is important for patients with suspected multiple sclerosis, but it may not always be urgent. If you have significant symptoms or concerns, it's recommended to initiate an assessment at the Vancouver Island Multiple Sclerosis clinic promptly. Early diagnosis and intervention can significantly impact your treatment journey.
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