Creating a New Referral

1. Select your patient

Both the Patient Search page and the Patient Detail page now include a Tools button.

Click on the button and select "CREATE REFERRAL" from the drop-down menu to display the referral form.

2. Fill out the form

The referral form has areas for you to enter different kinds of information:

Name, location and phone number of the doctor, hospital department or access center where the intervention will be performed.
Basic patient information including name, MRN, address and phone number, date of first dialysis, and other items.
Access information, including type and location, and date of creation. This is also where you will specify the requested procedures and the indications.
Clinical information such as most recent hematocrit and factors that should be taken into account like diabetes.
Information about your dialysis facility

Notes can be added to the right of each section. Additional space to enter notes appears when needed.

Vasc-Alert will prefill a lot of the patient information based on the patient's history.

You must include the following information before you can save the referral:

Name of the nephrologist
Patient address
At least one indication for the referral
Whether the patient has an X-Ray contrast allergy
Whether the patient has a heparin allergy
Whether the patient has a latex allergy
Whether the patient is diabetic
Whether the patients is taking Coumadin or any other lytic agents
Whether the patient is competent to sign

3. Generate the referral packet

When you are finished with the form, click on the save referral form for printing button at the bottom of the online form. Vasc-Alert creates a referral packet which includes the the referral form and a copy of the most recent Patient Detail report.

4. Print the referral packet

Download an example (PDF format)

Use the Print Referral Form button to print out the referral and Patient Detail report. Then click "return to patient info."