Essential referral information Without this information the referral will be returned General referral information including current BMI History of - symptoms, rate of deterioration of the condition...
Essential referral information Without this information the referral will be returned General referral information Describe functional assessment, (pinch grip, knob grip, key grip, pen grip) XR...
Essential referral information Without this information the referral will be returned General referral information Description of: onset, duration, frequency and quality functional impact of vertigo...
Essential referral information Without this information the referral will be returned Neurology history (i.e. stroke’s, progressive neurological disease) Previous history head/neck oncological...
Essential referral information Without this information the referral will be rejected Diagnostic audiology assessment (Highly desirable where available and not cause significant delay)
Essential referral information Without this information the referral will be returned Details of previous treatment (including systemic and topical medications prescribed) including the course and...
Essential referral information Without this information the referral will be returned General referral information Neurology/neurosurgery history Details of previous treatment (including systemic and...
Essential referral information Without this information the referral will be returned Smoking and alcohol history USS +/- CT neck results ELFT FBC ESR results
Essential referral information Without this information the referral will be rejected Description of: hearing loss i.e. one or both sides change in hearing loss Diagnostic audiology assessment (Highly...