Get Inter Provider Transfer Form - Demon Internet - Dorse-48577-001 Dvs Demon

This guide provides a comprehensive overview of how to complete the INTER PROVIDER TRANSFER FORM - Demon Internet - Dorse-48577-001 Dvs Demon. Each section of the form is outlined with clear instructions to ensure accurate completion.

Follow the steps to successfully fill out the form.

1. Click the ‘Get Form’ button to access the document and open it in your preferred editing tool.
2. In the 'Referring Organisation' section, fill in the date of decision to refer, organisation name, and organisational code of the receiving organisation.
3. Provide the details of the referring clinician, including their name and referrer code, along with the referring specialty/function.
4. Enter the contact name and details for the referring organization, including the contact telephone number and email address.
5. In the 'Patient Details' section, input the patient's title and name, date of birth, and correspondence address. Ensure that the NHS number is also included.
6. List the patient's contact details, including telephone number, alternative number, mobile number, and postcode.
7. For the GP details, enter the GP name and practice code.
8. Indicate whether the patient's 18-week pathway is open by selecting 'YES' or 'NO'. If applicable, provide the latest 18-week clock start date and the unique pathway identifier.
9. In the 'Receiving Organisation Details' section, enter the receiving organisation name and code. Also provide the name of the receiving clinician and the receiving treatment function (specialty).
10. Lastly, record the date and time the transfer was received by the receiving organisation.
11. Once you have filled out all necessary fields, ensure to save your changes. You can also download, print, or share the completed form as required.

Complete your documents online today for a smoother transfer process.