Get Dr. Ahmed Al-ghoul Referral Form (click To ... - Seema Eye Care

Filling out the Dr. Ahmed Al-Ghoul Referral Form is a crucial step in facilitating the referral process for patients requiring specialized eye care. This guide will walk you through each component of the form to ensure that all necessary information is accurately captured.

Follow the steps to complete the referral form effectively.

1. Click ‘Get Form’ button to acquire the referral form and access it for editing.
2. Begin by entering the patient's name, date of birth, and AHC in the designated fields. Ensure that the spelling is accurate for identification purposes.
3. Fill in the patient's address and telephone number. This information is vital for any communications regarding the referral.
4. Provide the patient's email address if available to help streamline communication.
5. Enter the referring doctor’s name, their practice ID, and contact information, including the office telephone, fax number, and address.
6. Indicate the date of referral clearly to document when the referral was made.
7. Select the reason for referral by circling the appropriate option: OD (right eye), OS (left eye), or OU (both eyes). Include specific options such as cataract surgery, corneal surgery, or other medical reasons by marking the relevant choices.
8. In the additional comments section, provide any further information that may be pertinent to the referral, especially if 'Other' options are selected.
9. Document the last date the patient was seen and any relevant measurements, including intraocular pressure and refraction values for both eyes.
10. If applicable, complete the referring office stamp section to authenticate the referral. This may include office address or other identifying features.
11. Review all entered information carefully for accuracy. Once satisfied, you can save changes, download, print, or share the completed form as needed.

Take the first step in referring a patient by completing the Dr. Ahmed Al-Ghoul Referral Form online today.