Get Glen Sather Clinic

Filling out the Glen Sather Clinic referral form online is a straightforward process designed to facilitate effective communication between patients and healthcare providers. This guide will help you navigate each section of the form with clear instructions, ensuring that all necessary information is accurately completed.

Follow the steps to efficiently complete your referral form.

1. Click 'Get Form' button to retrieve the referral form and open it for editing.
2. Begin with the patient information section. Enter the patient's name, gender, date of birth (in DD/MM/YYYY format), age, complete address, and phone numbers (home and cell). Ensure that the Personal Health Number (PHN) is also included.
3. Next, move to the clinical details section. Provide the date of the injury and specify the affected body part. Indicate whether the injury is acute (less than 4 weeks), a flare-up of a pre-existing condition, or a chronic condition. Additionally, describe the activity or sport affected.
4. In the reason for referral section, provide detailed information regarding the mechanism of injury, present symptoms, any treatments undertaken to date, and the effect on the individual's sport or exercise participation.
5. Fill out the pertinent past medical history and medications if applicable. This helps the clinic understand the patient's background and current medication regimen.
6. If applicable, indicate any imaging or investigations that have been performed. You may check the relevant boxes for X-ray, CT, ultrasound, MRI, bone scan, or select 'N/A' if not applicable.
7. Complete the referring health professional information section by printing the name, PRACID, mailing address, phone number, and fax number. Also, provide the date and signature to validate the referral.
8. Before submitting, review all inputs for accuracy. Once confirmed, save the changes, and then download, print, or share the completed form as needed.

Complete your referral form online today for prompt assistance from the Glen Sather Clinic.