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MOORFIELDS CROYDON RAPID ACCESS EYE CLINIC REFERRAL FORM Patient DetailsReferrer DetailsFirst Name: Surname: DOB: Address: Postcode: Contact No: Email:Name: Role: Address: Postcode: Contact No: Email:Is.

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How to fill out the Moorfields Croydon Rapid Access online

Filling out the Moorfields Croydon Rapid Access form online is a straightforward process designed to streamline patient referrals for urgent ophthalmological care. This guide provides clear, step-by-step instructions to ensure that all necessary details are accurately submitted.

Follow the steps to complete the Moorfields Croydon Rapid Access form online.

  1. Click 'Get Form' button to obtain the form and open it in the editor.
  2. Enter the patient details in the designated fields. This includes the patient's first name, surname, date of birth (DOB), address, postcode, contact number, and email address.
  3. Provide the referrer details in the appropriate fields, including the name, role, address, postcode, contact number, and email address of the person referring the patient.
  4. Indicate the patient's status by selecting one of the options: inpatient or outpatient. If the patient falls under other categories, please specify.
  5. Detail the presenting complaint and the duration of symptoms by filling in the respective fields provided.
  6. For visual acuity, enter the best corrected vision for both eyes. Ensure to test both the right eye and the left eye in all patients.
  7. Include clinical findings and any relevant history in the designated section. You may attach photos, visual fields, or scans if necessary on the following page.
  8. Select the review needed timeframe by choosing one of the options: same day, 1-2 days, 1 week, or 2 weeks.
  9. Verify that all fields are completed. Incomplete forms will be rejected.
  10. Save the completed form as a PDF and email it to moorfields.croydonurgentcare@nhs.net. Ensure to follow up with a phone call if a same-day review is required.

Complete your documents online to ensure prompt patient care.

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Please contact the hospital first for appointments at the following sites: Northwick Park 020 3182 4000, 020 3182 4030, 020 3183 4028 or 020 3183 4029; or email moorfields.nwpinfo@nhs.net. Ealing 020 8967 5766. St Ann's 020 7566 2841 or 020 8211 8323.

Waiting time information Average waiting time for first outpatient appointment at this hospital for this specialty11 weeksAverage waiting time for treatment at this hospital for this specialty10 weeks

Help your patients self-refer There is no need for a referral, your patients can simply call 0800 328 3421 to book their appointment, available Monday – Friday, 2pm - 6pm.

A&E is not a “walk in” clinic and you will be asked to see your optician or GP if you do not have an emergency.

If this is your first appointment at Moorfields, please email the booking centre at moorfields.outpatientbookingsbc@nhs.net - Please note, we are unable to answer queries for patients who attend our clinics at Croydon, Purley, Bedford, Northwick Park and Ealing through this email address.

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