Get Referral Form - Hyperbaric Unit

Completing the Referral Form for the Hyperbaric Unit is a crucial step in ensuring that patients receive the necessary care. This guide will walk you through each section of the form, offering detailed instructions to help you fill it out accurately and effectively.

Follow the steps to complete your referral form with ease.

1. Press the ‘Get Form’ button to access the form and open it in your editing tool.
2. Fill in the 'Patient Name' field with the full name of the person receiving the treatment. Ensure to include their date of birth (DOB) in the specified area.
3. Enter the Personal Health Number (PHN) of the patient in the appropriate field. This is important for identification purposes.
4. Provide the complete address of the patient, including street name, city, and postal code.
5. Input the phone numbers for both home and work, ensuring that both fields are filled out for reliable communication.
6. Clearly state the diagnosis related to the referral in the designated section, which helps in assessing the patient's condition.
7. Use the 'Reason for Referral' section to elaborate on why the patient needs to be referred to the Hyperbaric Unit. This should be detailed for clarity.
8. Provide the name and MSC number of the family doctor. Also, include their phone and fax numbers to facilitate communication.
9. Fill in the details for the referring doctor, including their name, MSC number, phone, and fax numbers.
10. Indicate whether surgery has been performed by checking the box that applies and providing the date of surgery if applicable.
11. If an appointment has been booked, indicate this and specify the date and time of the appointment, alongside a note if the patient has been notified.
12. Attach relevant documents as indicated: patient history, CT scan results, lab results, ultrasound reports, cardiac echo, ECG, nuclear medicine, or biopsy results.
13. Review the completed form carefully to ensure all information is accurate, then save your changes. You can download, print, or share the form as necessary.

Complete your documents online to ensure efficient processing of the referral.