Follow the steps to fill out the OHCWA Referral Form with ease.

1. Click the ‘Get Form’ button to access the form and open it in the online editor.
2. Complete the 'Referred from' section by selecting the appropriate option from the provided list, indicating the source of the referral.
3. In the 'Referring dentist' field, input your full name. Next, fill out the 'Patient name' section, ensuring to include the surname and given name, followed by the registration number if applicable.
4. Enter the patient's date of birth, address, and telephone number in the designated fields. Ensure accuracy to facilitate communication.
5. Specify the reason for referral by selecting one of the categories such as Endodontics, Oral Medicine, or Orthodontics, among others.
6. Indicate the urgency of the referral by checking the appropriate box for High, Medium, or Waiting List.
7. Provide detailed information in the relevant medical history section, including any critical health information that the recipient needs to be aware of.
8. If the referral involves oral surgery for wisdom teeth, specify the number of teeth and whether they are impacted, along with the need for general anaesthesia.
9. Sign and date the form, confirming that the information provided is accurate to the best of your knowledge.
10. Lastly, enclose any required documentation, such as relevant x-rays and eligibility forms, and save your changes. You can then download, print, or share the completed form as needed.

Complete the OHCWA Referral Form online today for a seamless referral process.