Get Wet Amd Rapid Access Referral Form

Filling out the Wet Amd Rapid Access Referral Form online is a straightforward process designed to facilitate referrals for patients with age-related macular degeneration. This guide will provide you with detailed instructions on completing each section of the form with ease.

Follow the steps to successfully complete the form online.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Begin by entering the name of the consultant in the designated field at the top of the form.
3. Fill in the hospital contact details accurately, ensuring all information is current.
4. Move on to the patient details section. Provide the patient's full name, date of birth, and hospital number if known. Additionally, fill in the patient's address and contact telephone numbers.
5. Complete the GP details by entering the name of the general practitioner and the surgery name.
6. In the optometrist details section, input the optometrist's name, practice, GOC number, address, telephone, and fax details as applicable.
7. Indicate the affected eye, selecting right, left, or both where appropriate.
8. Document any previous AMD history for each eye, along with information on myopia and any other related conditions.
9. In the presenting symptoms section, ensure you mark at least one symptom as 'yes' by placing an 'X' in the correct box.
10. For the findings section, input the best corrected visual acuity and the presence of any macular drusen, haemorrhage, subretinal fluid, or exudate in the specified fields.
11. In the space provided for comments, add any additional observations relevant to the referral.
12. Review all entries for completeness and accuracy, then save your changes. You have the option to download, print, or share the completed form as needed.

Complete your Wet Amd Rapid Access Referral Form online today for efficient patient referrals.