Doernbecher Referral Form

What is the Doernbecher Referral Form

The Doernbecher Referral Form is a specialized document used to facilitate the referral of patients to Doernbecher Children's Hospital, part of Oregon Health & Science University (OHSU). This form is essential for healthcare providers to ensure that patients receive the appropriate care and services offered by the hospital. It collects necessary patient information, medical history, and the referring provider's details to streamline the referral process.

How to use the Doernbecher Referral Form

Using the Doernbecher Referral Form involves several straightforward steps. First, healthcare providers must complete the form with accurate patient information, including demographics and medical history. Next, the referring provider should specify the reason for the referral and any specific services required. Once completed, the form can be submitted electronically or via traditional mail, depending on the provider's preference. Utilizing electronic submission can expedite the referral process and ensure timely care for the patient.

Steps to complete the Doernbecher Referral Form

Completing the Doernbecher Referral Form requires careful attention to detail. Follow these steps for successful submission:

• Gather patient information, including full name, date of birth, and contact details.
• Document the patient's medical history and any current medications.
• Clearly state the reason for the referral and any specific services needed.
• Include the referring provider's information, including name, contact number, and practice details.
• Review the form for accuracy and completeness before submission.

Legal use of the Doernbecher Referral Form

The Doernbecher Referral Form is legally binding when completed correctly and submitted according to the guidelines set forth by OHSU. It is important for healthcare providers to ensure that the information provided is accurate and truthful, as any discrepancies could lead to legal implications. Additionally, compliance with healthcare regulations, such as HIPAA, is crucial to protect patient privacy and maintain the integrity of the referral process.

Form Submission Methods

There are multiple methods to submit the Doernbecher Referral Form, allowing flexibility for healthcare providers. The options include:

• Online Submission: Providers can fill out and submit the form electronically through OHSU's secure portal, ensuring a faster processing time.
• Mail: The completed form can be printed and mailed to the appropriate department at Doernbecher Children's Hospital.
• In-Person: Providers may also deliver the form directly to the hospital, which can be beneficial for urgent referrals.

Key elements of the Doernbecher Referral Form

The Doernbecher Referral Form includes several key elements that are critical for its effectiveness:

• Patient Information: Essential details such as name, date of birth, and contact information.
• Medical History: A summary of the patient's medical background and current health status.
• Referral Reason: A clear explanation of why the referral is being made and what services are needed.
• Provider Information: Details of the referring healthcare provider, including their qualifications and contact information.