Get Joint Replacement Access Clinic (jrac) Referral Form For Patients ...

Filling out the Joint Replacement Access Clinic (JRAC) Referral Form accurately is essential for facilitating timely and appropriate medical care for patients experiencing osteoarthritis and rheumatoid arthritis. This guide will assist you in navigating each section of the form online, ensuring that you provide all necessary information.

Follow the steps to complete the referral form effectively.

1. Press the ‘Get Form’ button to retrieve the referral form and open it in your preferred editor.
2. In the 'Dr. Referring' section, enter the name of the referring physician.
3. Fill in the 'Date' field with the date you are completing the form.
4. Provide the office phone number and fax number of the referring physician's office in the designated fields.
5. Specify the orthopedic surgeon you want to refer the patient to by selecting from the provided list.
6. In the 'PATIENT' section, enter the patient's name, phone number, date of birth, personal health number (PHN), cell number, work number, and full address including postal code.
7. In the 'Reason for Referral' section, briefly outline the reason for the patient's referral.
8. Indicate if recent X-rays (within 6 months) are needed before the appointment by listing the required views for knee, hip, and ankle if applicable.
9. Select the location of the X-ray by checking the appropriate box for North Shore, West Vancouver, LGH, or other.
10. Ensure to list any additional reports required to be faxed with the referral, like imaging reports or prior blood work.
11. Once all the fields are completed, review the form for accuracy. Save the changes, and choose to download, print, or share the form as necessary.

Complete your JRAC referral form online today to ensure prompt medical attention.