Four Winds Adult Psychiatry Telephone Consultion Request Form for Primary Care Physicians

Purpose of the Four Winds Adult Psychiatry Consultation Request Form

The Four Winds Adult Psychiatry Consultation Request Form is designed for primary care physicians to facilitate a structured referral process for patients requiring psychiatric evaluation and treatment. This form helps ensure that essential patient information is communicated effectively, allowing psychiatrists to understand the patient's needs and history before the consultation. It plays a crucial role in streamlining the referral process, ensuring timely access to mental health services for patients.

How to Use the Four Winds Adult Psychiatry Consultation Request Form

To use the Four Winds Adult Psychiatry Consultation Request Form, primary care physicians should first download the form from the appropriate source. Once obtained, physicians must fill out the required fields, including patient demographics, medical history, and specific reasons for referral. After completing the form, it should be submitted according to the guidelines provided, typically via fax or secure email, ensuring that patient confidentiality is maintained throughout the process.

Steps to Complete the Four Winds Adult Psychiatry Consultation Request Form

Completing the Four Winds Adult Psychiatry Consultation Request Form involves several key steps:

1. Download the form from the designated source.
2. Fill in patient information, including name, date of birth, and contact details.
3. Provide a detailed medical history, including any current medications and previous psychiatric treatments.
4. Clearly state the reason for the referral, highlighting any urgent concerns.
5. Review the completed form for accuracy and completeness.
6. Submit the form securely to the designated psychiatric service.

Legal Use of the Four Winds Adult Psychiatry Consultation Request Form

The legal use of the Four Winds Adult Psychiatry Consultation Request Form is essential to ensure compliance with healthcare regulations. The form must be filled out accurately, as any misinformation can lead to legal ramifications for both the referring physician and the psychiatric service. It should also adhere to privacy laws, such as HIPAA, ensuring that patient information is handled securely and confidentially throughout the referral process.

Key Elements of the Four Winds Adult Psychiatry Consultation Request Form

The Four Winds Adult Psychiatry Consultation Request Form includes several key elements that are vital for effective communication between primary care physicians and psychiatrists:

• Patient Information: Essential demographics and contact details.
• Medical History: A comprehensive overview of the patient's health, including psychiatric history.
• Reason for Referral: Specific concerns or symptoms prompting the referral.
• Current Medications: A list of any medications the patient is currently taking.
• Emergency Contact: Information for a person to reach in case of urgent issues.

Obtaining the Four Winds Adult Psychiatry Consultation Request Form

The Four Winds Adult Psychiatry Consultation Request Form can typically be obtained through the healthcare facility's website or directly from the psychiatric service. Primary care physicians should ensure they have the most current version of the form to avoid any issues during the referral process. It may also be available in physical form at the healthcare provider's office for convenience.