A&E Referral Form for TIA 2026

1. Click ‘Get Form’ to open the A&E Referral Form for TIA in our editor.
2. Begin by entering the Patient Data. You can either type in the details or use a sticky label for convenience. Fill in the patient's name, gender, date of birth, NHS number, practice address, telephone number, postcode, and email.
3. Next, provide GP details using a sticky label or stamp if available. This section includes the GP's name and contact information.
4. If applicable, include Carer Details by filling in their name and contact numbers.
5. Document the Date of ED assessment and any relevant event dates along with their times and duration of symptoms.
6. Complete the FAST Test section by marking 'Y' or 'N' for each symptom observed: face weakness, arm weakness, and speech disturbance.
7. Proceed to the ABCD2 Test section where you will score based on clinical features at the time of TIA. Ensure to calculate total scores accurately as they indicate risk levels.
8. In the Clinical Description area, record vital signs such as pulse and blood pressure along with any additional risk factors like previous strokes or heart disease.
9. Finally, review all sections for completeness before saving your form. Utilize our platform’s features to sign and share your document securely.

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