Essential referral information Without this information the referral will be returned History of symptoms Smoking history History of occupational exposure (eg asbestos) or TB exposure Cardiac history...
Essential referral information Without this information the referral will be returned Details of any previous: cardiac disease respiratory disease venous thromboembolism Degree of functional...
Essential referral information Without this information the referral will be returned Description of lower respiratory tract symptoms with supporting investigations e.g. CXR, sputum culture, WCC...
Essential referral information Without this information the referral will be returned Details of symptoms including duration and severity CT scan Sputum culture (including TB culture) FBC, ELFT, ESR...
Essential referral information Without this information the referral will be returned Details and timeline of symptoms including variability and severity Relevant medical conditions Relevant imaging...
Essential referral information Without this information the referral will be returned History of sleep disorder including duration and severity of symptoms, snoring, witnessed apnoeas, restless sleep...
Essential referral information Without this information the referral will be returned History of sleep disorder including frequency, duration and severity of symptoms Management to date and efficacy...
Essential referral information Without this information the referral will be returned Duration and severity of symptoms including dyspnoea, cough, chest pain, weight loss, night sweats, systemic...
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' All referrals Degree of...
Essential referral information Without this information your referral will be returned General referral information Assessment report including ROM measurement Details of functional impairment (Table...