Get Emergency Ent Referral Formdocx - Royal-surrey

Filling out the Emergency ENT Referral Form is essential for ensuring that patients receive timely care. This guide provides clear, step-by-step instructions on how to complete the form accurately, ensuring all necessary information is included for an efficient referral process.

Follow the steps to complete your Emergency ENT Referral Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the patient details section. Provide the patient's full name, title, address, postcode, and date of birth. Ensure all fields are legibly completed.
3. Input the patient's contact numbers. It is crucial to provide more than one contact number, including mobile, home, and work telephone numbers, to prevent any issues with receiving appointment notifications.
4. Complete the GP details section. Include the name of the patient's general practitioner, the name of their surgery, and the surgery's address and contact number.
5. Fill in the reason for referral. Clearly state the medical case or issue that requires attention.
6. If you are not the patient's GP, complete the referrer details section. Include your name, contact number, and the name of the referring trust or department, such as Accident & Emergency.
7. Complete the date of referral field by entering the current date.
8. In the prioritization section, specify whether the referral is for emergency clinic or consultant clinic and, if applicable, state which consultant it concerns. Indicate whether the referral is routine, urgent, or other, and sign and date the section.
9. Review all information provided for accuracy and completeness. Check that all mandatory fields have been filled out.
10. Once everything is complete, you can save changes, download, print, or share the form as needed.

Complete your Emergency ENT Referral Form online today to ensure quick and efficient patient care.