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  • Formulario De Doctor

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EVALUACIN FSICA PREPARTICIPACINFORMULARIO DE HISTORIAL MDICO(Nota: Este formulario debe ser rellenado por el paciente y padre/madre antes de ver al doctor. El doctor debe mantener este formulario.

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Es el envío de pacientes o elementos de ayuda diagnóstica por parte de un prestador de servicios de salud, a otro prestador para atención o complementación diagnóstica que, de acuerdo con el nivel de resolución, dé respuesta a las necesidades de salud.

Documento con información importante sobre un procedimiento o tratamiento médico, un ensayo clínico o pruebas genéticas. También incluye información sobre los posibles riesgos y beneficios.

Esta incluye: Nombre del médico que refiere e información de contacto. Nombre del paciente. Fecha de nacimiento del paciente. Dirección y teléfono del paciente. Diagnóstico e historial de tratamiento del paciente.

Se entiende por referencia médica el "proceso por medio del cual se envía a un paciente para su atención de un nivel a otro, dentro del mismo nivel, o de una institución a otra con mayores recursos para el diagnóstico y tratamiento" (Ministerio de Salud, 1978).

Consejos para aplicar un formulario médico Incluye el nombre y la información de contacto del médico del paciente. ... Agrega una sección que incluya los comentarios de seguimiento del médico. Incluye una sección de “progreso” en la que se anoten todas las actualizaciones y cambios.

Escriba su nombre completo (primer nombre y apellido). Escriba el código de área y número de teléfono de su casa. electrónico Escriba su dirección de correo electrónico. Antes de continuar con el formulario, elija un plan de salud para cada miembro de su familia.

Elementos de una referencia personal Nombre completo de la persona que está haciendo la referencia. Número del documento de identidad (DNI, pasaporte...). Dirección de su domicilio y dirección del trabajo previo. Números telefónicos y correo electrónico.

Hoja de referencia Es un formato simple pero muy importante para registrar los datos básicos del paciente, poder comunicarnos con él y además saber con detalle lo que el médico que lo refiere desea investigar.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232