Essential referral information Without this information the referral will be returned Previous orthopaedic conditions and operations History of – symptoms, date, time, mechanism, severity or evolution...
Essential referral information Without this information the referral will be returned This is not a CPC guideline. West Moreton staff please select 'CPC not applicable' Mandatory for all referrals: X...
Essential referral information Without this information the referral will be returned Details of relevant signs and symptoms Details of all treatments offered and efficacy Past medical history and...
Essential referral information Without this information the referral will be returned Details of relevant signs and symptoms Details of all treatments offered and efficacy BP (BP measurements on both...
Essential referral information Without this information the referral will be returned Details of all treatments offered and efficacy Relevant previous medical history and co-morbidities (especially...
Essential referral information Without this information the referral will be returned Details of relevant signs and symptoms Details of all treatments offered and efficacy Past medical history...
Essential referral information Without this information the referral will be returned General referral information Details of relevant signs and symptoms including duration and frequency of episodes...
Essential referral information Without this information the referral will be rejected Medication history ELFTs, FBC, TSH results All available ECGs (including an ECG showing SVT if possible)
Essential referral information Without this information the referral will be returned Details of all treatments offered and efficacy Relevant medical history Description of syncopal/pre-syncopal...
Essential referral information Without this information the referral will be returned This is not a CPC guideline. West Moreton staff please select 'CPC not applicable' Signs and symptoms of disease...