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How to use or fill out General Paediatric Consultation Clinic Referral Form PRINT
- Click ‘Get Form’ to open it in the editor.
- Begin by placing the patient sticker at the designated area on the form. This helps in identifying the patient easily.
- Fill in the Patient Information section, including Date of Birth, Last Name, First Name, Gender, Guardians’ Names, Email, and both home and mobile phone numbers.
- If an appointment is pre-booked, enter the Time and Date of the appointment. If not pre-booked, indicate the referral urgency by selecting Urgent, Semi-urgent, or Non-urgent.
- Specify whether the patient has a primary care provider and provide their name if applicable. Indicate if a paediatric opinion or second opinion is needed.
- In the Reason for referral section, attach any relevant SickKids ED Summary of Care documents as required.
- Complete the Name of referring MD/NP and Billing Number fields before signing at the bottom of the form.
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See more General Paediatric Consultation Clinic Referral Form PRINT versions
| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2019 | 4.8 Satisfied (91 Votes) |
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