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How to use or fill out Orthopedic Assessment Clinic PRIMARY HIP AND KNEE
- Click ‘Get Form’ to open it in the editor.
- Begin by selecting one of the three referral options. Choose either the next available surgeon within a specific zone, a specific surgeon, or self-management only.
- Indicate the affected joints by checking the appropriate boxes for left hip, right hip, left knee, or right knee.
- Provide additional patient information regarding arthritis symptoms and previous treatments. Check 'Yes' or 'No' as applicable.
- Fill in any other relevant medical conditions that may affect surgery eligibility and provide details about medications and allergies in the space provided.
- Complete the referral source section by printing your name, entering your CPSNS number, signing, and dating the form.
- Ensure all required fields are filled out accurately before submitting to avoid delays in processing.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2018 | 4.8 Satisfied (20 Votes) |
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