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Seating clinic referral form

Albertahealthservices cafrm-19619Last Name First Name Generic Referral - Alberta Health Services 2025

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4.9 out of 5

38 votes

The document is a referral form for a seating clinic, detailing the necessary information and requirements for clients seeking assessment and equipment related to their seating needs. It includes sections for client demographics, medical history, current mobility status, and specific reasons for referral. Additionally, it outlines the documentation required to accompany the referral, such as photos and consent forms, as well as considerations for funding sources and special needs.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the client's legal last name and first name in the designated fields. Ensure accuracy as this information is crucial for identification.
Fill in the date of birth (DOB) using the format dd-Mon-yyyy, and provide the Unique Lifetime Identifier (ULI) if applicable.
Select the administrative gender from the options provided. If necessary, indicate if a caregiver will accompany the client during assessments.
Complete sections regarding medical status, including primary diagnosis and any relevant medications that may affect seating needs.
Provide detailed information about current mobility aids, including wheelchair specifications and any special considerations required for the client.
Finally, review all entered information for accuracy before submitting your referral through our platform.

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Versions	Form popularity	Fillable & printable
2021	4.9 Satisfied (38 Votes)
2010	4.5 Satisfied (33 Votes)
2007	4.6 Satisfied (38 Votes)

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What is going on with Alberta Health Services?

According to the Alberta government, more than 16,000 Alberta Health Services staff members have been transferred to four new health agencies (Acute Care Alberta, Primary Care Alberta, Recovery Alberta and Assisted Living Alberta) since the reorganization was announced in November 2023.

Is Alberta Health the same as Alberta Health Services?

Alberta Health Services (AHS) is the provincial health agency tasked with delivering health services to Albertans. Alberta Health is the government department that sets policy, legislation and standards for the health system in Alberta.

What is Alberta healthcare called?

Alberta Health Services (AHS) is the single health authority for the Canadian province of Alberta and the largest integrated provincial health care system in Canada. Headquartered in Edmonton, AHS delivers medical care on behalf of the Government of Albertas Ministry of Health.

How do I contact Alberta Health Services?

Before we jump into how to check for non-Alberta government coverage, its important to understand healthcare numbers for patients. Every patient in Alberta is given a Unique Lifetime Identifier (ULI) number. If they have Alberta Health coverage, this ULI number is the same as their Personal Healthcare Number (PHN).

What is Alberta Health Plan called?

Alberta Health Care Insurance Plan (AHCIP)