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Get Chas Referral Form For Referrals To Subsidised Specialist... 2020-2025
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How to fill out the CHAS Referral Form for Referrals to Subsidised Specialist outpatient Clinics online
Filling out the CHAS Referral Form is a crucial step in securing access to subsidised specialist care. This guide provides clear, step-by-step instructions to assist users in completing the form accurately and efficiently online.
Follow the steps to successfully complete your CHAS Referral Form.
- Click ‘Get Form’ button to obtain the form and open it for completion.
- In Part I: SOC Appointment Details, fill in the department referred to, institution if relevant, appointment date, time, and appointment location. If applicable, include the contact number.
- Proceed to Part II: Patient’s Particulars. Enter the patient’s full name, gender (please circle accordingly), NRIC number, and contact number. Select the appropriate card type from CHAS Blue, CHAS Orange, Pioneer Generation (PG), or Public Assistance (PA) and provide the expiry date.
- Move to Part III: Doctor’s / Dentist’s Referral. Detail the patient’s medical history, presenting symptoms or diagnosis, and management plan. Attach any relevant investigation results or additional notes if more space is required.
- Complete Part IV: Doctor’s Acknowledgment. The practitioner must confirm their clinic’s status as a CHAS clinic, verify that the patient is a CHAS/PG/PA cardholder, and acknowledge that their patient will be assigned to a subsidised specialist.
- Ensure that the practitioner enters their name, signature, MCR/DCR number, date, clinic name, clinic address, clinic contact number, and clinic email.
- Remind the patient to bring the completed referral form along with their CHAS/PG/PA card and NRIC for verification during their SOC appointment.
- Finally, save any changes made, and download, print, or share the completed form as needed.
Start filling out your CHAS Referral Form online to secure your specialist appointment today.
When filling out a referral form, start with basic patient information like name, age, and contact details. Then, clearly outline the reason for the referral, accompanying medical history, and any tests or treatments already undertaken. Make sure to use the CHAS Referral Form For Referrals To Subsidised Specialist to ensure all mandatory fields are included for effective communication with the specialist.
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