Get Fax To Jpocsc Central Intake (604-953-9701) - Fraser Health

This guide provides clear and supportive instructions on completing the FAX To JPOCSC Central Intake form for Fraser Health. By following the steps outlined below, users can efficiently submit important patient referral information online.

Follow the steps to complete the form accurately and effectively.

1. Press the ‘Get Form’ button to access the document and open it for editing.
2. Fill in the 'Patient Information' section, including the patient's full name, date of birth, gender, personal health number (PHN), insurance details, address, and contact methods.
3. Proceed to the 'Referral Information' section, entering the referring health care provider's name, title, contact information, and the priority of the referral based on urgency.
4. Provide the reason for referral and any relevant medical history that supports the urgency or necessity of the referral.
5. Indicate any necessary isolation precautions and if an interpreter is required. If needed, specify the language.
6. Complete the 'Medical Day Care' section, detailing the primary and secondary diagnosis, and attaching any other required documents such as orders, medical history letters, or bloodwork results.
7. For any medication orders, specify details including frequency and any special instructions provided by the physician.
8. Obtain the prescriber’s signature, along with their printed name or college ID, and fill in the date.
9. Review the completed form for accuracy, and if everything is correct, save the changes and download, print, or share the form as necessary.

Take the first step towards submitting your referral by filling out the form online today.