Get Uk Evelina London Childrens Hospital Paediatric Nephrology ­referral Form 2018-2025

Filling out the UK Evelina London Childrens Hospital Paediatric Nephrology Referral Form online is essential for ensuring that your referral is processed efficiently. This guide provides step-by-step instructions to help you navigate each section of the form with confidence.

Follow the steps to successfully complete the referral form online.

1. Press the ‘Get Form’ button to download the referral form and open it in your preferred editor.
2. Begin by entering the referral date and time in the designated field to establish when the referral is being submitted.
3. Fill in the referrer details section, including the name of your hospital or GP, the referring consultant, and your own contact information.
4. Next, complete the patient details section with the patient's given name, surname, date of birth, address, contact number, NHS number, and the GP’s name and address.
5. In the case details section, indicate if the patient is a previous patient at Evelina London and provide the Evelina London Hospital number if available.
6. State whether the patient is known to the Paediatric Nephrology team and provide any relevant information regarding previous discussions with the team.
7. In the main diagnosis section, specify what questions you would like answered by the paediatric nephrology team.
8. Detail the presenting symptoms, medical history, current medications, and clinical assessments to provide a comprehensive overview of the patient’s condition.
9. Fill out the observations section, including date, time, blood pressure, recent weight, and recent height.
10. Report blood results in the relevant biochemistry, haematology, and blood gas sections, providing specific values along with their respective dates and times.
11. Complete the urine results by entering data for biochemistry, microscopy, culture, and dipstick results.
12. Finally, include any imaging results and communication notes or advice given, as well as any other relevant information.
13. Once all sections are completed, remember to save changes, download, print, or share the form as needed.

Complete your referral form online today to ensure timely processing.