Get Physician Referral Letter Form-no Doctor.docx

This guide provides comprehensive instructions on how to complete the PHYSICIAN REFERRAL LETTER FORM-no Doctor.docx online. It simplifies the process, ensuring that users can navigate the form with ease and confidence.

Follow the steps to accurately complete the referral letter form.

1. Press the ‘Get Form’ button to download the PHYSICIAN REFERRAL LETTER FORM-no Doctor.docx and open it in your preferred editing software.
2. In the first field labeled 'DATE,' enter the current date that you are filling out the form. This should be formatted as MM/DD/YYYY.
3. Locate the section for 'REFERRING PHYSICIAN NAME.' Clearly provide your full name to ensure proper identification.
4. Complete the address fields by filling in your practice's address, city, province, and postal code.
5. Input your phone number in the designated field along with the fax number, if applicable.
6. In the field directed to 'To: Marijuana Access Canada,' verify that the address is correct, as this is where the letter will be sent.
7. Next, enter the name of the patient you are referring to the clinic under the section labeled 'I am referring my patient named…'
8. Fill in the OHIP number, which identifies the patient within the healthcare system, along with the date of birth to verify their identity.
9. In the space provided, describe the conventional medications and treatments that have previously been prescribed to the patient and state their ineffectiveness regarding their symptoms.
10. Conclude your letter by signing in the 'Physician’s Signature' area. Include the date you are signing and your billing number, if needed.
11. If available, affix your stamp in the designated area for added professionalism.
12. After reviewing all sections for accuracy, save your changes, and then download, print, or share the completed form as required.

Start filling out the PHYSICIAN REFERRAL LETTER FORM-no Doctor.docx online today for a seamless experience.