Get Referral To North Queensland Persistent Pain Management Servicetownsville Hhscdsuclinical Forms

This guide provides a comprehensive overview of the steps necessary to complete the Referral To North Queensland Persistent Pain Management Service Townsville HHSCDSU Clinical Forms online. This process aims to assist users in successfully navigating the form to ensure accurate and efficient referrals.

Follow the steps to fill out the referral form online.

1. Click ‘Get Form’ button to obtain the form and open it in the appropriate editor.
2. Begin by affixing the identification label in the designated area at the top of the form.
3. Input the patient’s family name and given name(s) in the corresponding fields.
4. Provide the patient’s address and date of birth accurately.
5. Select the appropriate sex option by marking the relevant box: Male, Female, or Indeterminate.
6. Under the referral section, fill in the referring doctor’s details including their name and organization.
7. Include the address and contact details of the North Queensland Persistent Pain Management Service.
8. Enter the patient’s details again, including any additional contact information such as phone numbers and postal address if it differs from the residential address.
9. Specify the patient’s Indigenous status and country of birth, along with their preferred language.
10. Enter the Medicare card number and expiry date. Indicate whether an interpreter is required.
11. Complete the referring medical officer’s details thoroughly, including any associated organizations or practices.
12. In the relevant medical and surgical history section, provide details pertaining to any previous examinations or treatments related to the patient's pain.
13. Document the reason for referral, pain history, and any findings from physical examinations in the specified fields.
14. Answer the questions related to drug dependence and substance abuse honestly, providing additional details where required.
15. List current medications and any known allergies or adverse reactions.
16. Assess and mark if the patient has undergone psychological assessments or has psychological stressors, ensuring to attach any relevant reports.
17. Confirm the patient's consent for the referral by obtaining their signature and the referring medical officer's signature along with the date.
18. Once completed, users can save changes, download, print, or share the form as per their requirements.

Complete your documents online today for a smooth referral process.