Get Canada Saskatchewan Spine Pathway Clinic Assessment And Referral Form 2016-2025

Filling out the Canada Saskatchewan Spine Pathway Clinic Assessment and Referral Form online can seem daunting. This guide will provide you with a step-by-step approach to ensure that you complete the form accurately and efficiently.

Follow the steps to accurately fill out the assessment and referral form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. Begin by entering the patient information. Provide the name, home address, contact numbers, and age in the designated fields.
3. Indicate whether this is an initial or follow-up assessment by selecting the correct option.
4. For back specific history, respond to the questions regarding pain location, overall level of disability, aggravating and relieving factors, and previous back problems or treatments.
5. Fill out the back specific physical exam section. Document the results of movement tests, irritative tests, reflex tests, motor tests, and any necessary observations regarding lower sacral function.
6. In the diagnosis and treatment section, select applicable patterns from the provided options and note any co-morbidities or additional comments.
7. If red flags are present, ensure to follow the instruction to refer directly to a surgeon. Otherwise, refer to the Spine Pathway Clinic for further evaluation.
8. Complete the referring practitioner’s details, including name, discipline, and signature, and include the date of completion.
9. Once all sections are completed, review your entries for accuracy. Save changes, download, print, or share the form as needed.

Take the next step to manage your health by completing the Saskatchewan Spine Pathway Clinic Assessment and Referral Form online.