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ENDOSCOPY REFERRAL ORDER FAX TO: 7817445479Page 1 of 1ORDERING PHYSICIAN: phone number: email or fax number: TIME FRAME:Urgent2 weeks3 monthsOther: PATIENT INFORMATION Patient Name: DOB Best phone.

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Endoscopy procedures should only be booked where results will have a significant impact on patient management. Colonoscopy patients may only be booked if the patient is able to comfortably tolerate full bowel preparation and mobilise from supine to lateral during the procedure.

Routine patients that would normally be seen within the next 4-6 weeks. D4: Chronic complaints that impact on quality of life and may result in mild or moderate disability – Routine patients that would normally be seen within the next 6-12 weeks.

The procedure may be uncomfortable, but it shouldn't be painful. You'll receive an intravenous sedative or another form of anesthesia. Someone should drive you home after the procedure. You lie on your left side during the procedure, which takes about 30 minutes.

Adults with indigestion or heartburn will be referred for an endoscopy if they have additional symptoms that need to be investigated, such as pain or difficulty swallowing or weight loss when they are over 55.

Your GP may refer you for an endoscopy if you're having certain symptoms. It will usually be done at an endoscopy unit in a hospital. There are different types of endoscopy that look at different parts of the body. The type of endoscopy you have will depend on your symptoms.

Four main indications are established for emergency endoscopy: acute gastrointestinal bleeding (variceal and nonvariceal), acute biliary pancreatitis and acute cholangitis.

Routine patients that would normally be seen within the next 4-6 weeks.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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