Get Eswl Urology (lithotripsy)

This guide provides clear, step-by-step instructions for completing the ESWL UROLOGY (LITHOTRIPSY) referral form online. By following these guidelines, users can confidently fill out the necessary details to ensure accurate submission.

Follow the steps to complete the form efficiently.

1. Press the ‘Get Form’ button to access the ESWL UROLOGY (LITHOTRIPSY) referral form and open it in your desired editing environment.
2. Begin by providing patient details in the designated sections, which include the surname, first name, medical records number (MRN), and date of birth (DOB). If available, attach a patient sticker for easy reference.
3. Next, complete the contra-indications checklist. Review each criterion carefully and tick 'Yes' or 'No' as applicable to the patient's situation, including absolute and relative contra-indications.
4. Fill in the patient's demographic information, including phone number and email address, and indicate their sex by selecting either 'F' or 'M'.
5. Indicate any additional sessions needed by checking the relevant boxes for the first, second, or third session options.
6. Provide relevant medical and drug history details, including allergies and specific details related to calculi to be treated. Circle the side (left or right) where the procedure will take place.
7. Document the referring consultant's name, telephone number, GMC number, date, and signature to validate the referral.
8. Finally, review all completed sections for accuracy. Once confirmed, users can save the changes, download, print, or share the completed form as necessary.

Complete your ESWL UROLOGY (LITHOTRIPSY) referral form online today for efficient processing.