Referral letter I am writing to request continuity of care and management of Mr XXX as he has been recovering from depression and self-poisoning and is due for discharge today. Regarding Mr XXX’s social and medical history, he is from china and lives with his mother. He requires an interpreter to translate English. He had an episode of depression and deliberate self-poisoning (DSP) after his divorce from wife. He has been experiencing depression and unemployment since his divorce and he was consulted a Chinese psychologist. However, his mother was not interested to give him psychiatric medications due to her Chinese beliefs. On 05/04/2011, Mr XXX presented the clinic with complaining of second episode of DSP and mental health problems. On observation, insomnia and mood decline was noticed and he was provided one to one counselling with transcultural mental health worker. His medication Mirtazipine dose was increased and his mother was counselled regarding the importance of antidepressant medications. His overall health condition has improved and he was provided close monitoring and support to manage his self-harm behavior. It would be appreciated if you could monitor Mr Zhang’s medication regime and please encourage him to perform regular exercise and job hunting. Kindly arrange his consultation with Chinese speaking doctor or arrange an interpreter. Please avoid prescribing benzo medications because he may use these to DSP.

Referral letter I am writing to request continued care and management of Mrs XXX as she has been recovering from an ischemic stroke and is transferred back to your facility today. On 10/05/2019, Mrs XXX was admitted to the hospital and diagnosed with left side ischemic stroke, middle cerebral artery, dyslipidemia and ongoing hypertension (BP-165/105mmhg). Subsequently, she was managed with tissue plasminogen and supplemental oxygen along with she was commenced on dipyridamole 200mg. During hospitalization, Mrs XXX was referred for language therapy to manage her aphasia and apraxia also she was attended daily physiotherapy sessions. The patient was mentioned some difficulties to perform her daily activities due to her upper extremity and right arm weakness. Her body mass index is 38 for her age and she was advised to reduce her body weight (5kg) along with she was informed to begin Mediterranean diet. Her overall health condition has improved during hospital stay. It would be appreciated if you could monitor Mrs WWW’s medication regime. Please encourage her to participate in physio and language therapy along with leisure and social activities. Please educate her about the importance of reducing body mass index and inform her to maintain her LDL below 70mg/dl and blood pressure less than 140/90mmhg. Please note, she requires further appointments to monitor her diabetes and depression also her neurology consultation will be on 22/05/2019.

referral letter 09/08/2014 Dr M McLaren Neurologist Suite 3 67, The Crescent Newtown Dear Dr McLaren Re: Mr Michael Weir DOB: 20/09/1970 I am writing to request further assessment and management of Mr XXX as his clinical signs and symptoms are suggestive of multiple sclerosis. Regarding Mr XXX’s social and medical history, he smokes regularly and reports no time for daily exercise and relaxation. The patient has a history of depression for which he has been taking sertraline hydrochloride since 2012 Recently, Mr XXX presented to the clinic and mentioned that weakness in left leg along with feeling tiredness, sluggishness and stress. During examination, his body mass index was 27.8 and his blood pressure was 90/80 mmhg. His blood reports revealed cholesterol-6.37 and low CBC, RBC, WBC, HB and hematocrit. He was advised to improve his diet, exercise and recreation along with smoking cessation. He was informed to check his hypercholesterolemia in 3 months and advised him to assess his overall health condition. Today, Mr XXX represented to the clinic and reported dizziness, occasional constipation, energy loss, mood swings since last visit, tingling sensation in hands, left leg weakness and two episodes of blackouts for few minutes. He has made changes in diet and exercise. However, he continues his smoking. On examination, loss of sensation noticed on his left and right hands along with diminished left patellar reflux. Therefore, he was advised to perform head and lumbar spinal CT. It would be appreciated if you could assess Mr XXX and please order an MRI if needed.

referral latter I am writing to request further assessment and management of XXX as he has been diagnosed with chest pneumothorax. Today, XXX presented to the hospital with complaints of difficulty in breathing, increasing chest pain especially when coughing and chest contusion after playing football. Subsequently, he was diagnosed with chest pneumothorax following a chest x ray. On observation, his oxygen saturation was 92% and he was restless. The patient was mentioned chest palpitation and breathlessness along with discoloration in his skin and mucous membrane noticed. Up on auscultation Kenneth mentioned chest pain and during inspection presents of air noticed on his right lung During hospitalization, XXX was administered Morphine 10mg and intra venous fluids. He was inserted an intercostal catheter (ICC) and it was attached to water sealed drainage. His ICC site was monitored and he was advised to take fluids and light meals It would be appreciated if you could monitor XXX’s vital signs and presents of blood in ICC insertion site. Please note, he has a history right femur fracture and he had an episode of concussion in 2018.

Referral letter I am writing to request continuity of care and full-time management of Mrs XXX as she is being transferred back to your facility today. On 08/11/2016, Mrs XXX was admitted to the hospital with complaints of right elbow dislocation and worsening dementia symptoms. The patient’s injured elbow was placed in a cuff with sling and she was commenced on Remeron 15mg and Atacand plus 32/12.5 25mg daily. Please note, she is on Oxycodone 5mg on day 3 and please continue if needed. During hospitalization, Mrs XXX complained incontinence of bladder. However, she was not willing to wear disposable briefs. She requires a wheel chair for mobility and assistance was provided for her shower and incontinent care. Her overall skin integrity has improved and she is medically fit for discharge. It would be appreciated if you could monitor Mrs XXX’s elbow healing process and bladder incontinence care. Please contact with physiotherapist for follow-up visits. Please advise the patient to visit the hospital on 28/11/2016 at 2pm. Please note, the patient’s spouse will transport her to Eventide.

Referral letter I am writing to request continuity of care and management of Mrs XXX. She is due for discharge today. Regarding Mrs XXX social and medical history, she lives with her husband and performs regular exercise. She consumes alcohol occasionally and avoids dairy products. The patient has a history of osteoporosis, hyperlipidemia, hypertension, coronary artery disease, right shoulder tendonitis and she underwent percutaneous trans coronary angioplasty in 2009.The patient has a family history of cancer and depression. She is on Simvastatin, Aspirin, Furosemide, Alendronate, Calcium and vitamin E medications. On 28/06/2017 Mrs XXX was admitted to the hospital and diagnosed with left neck of femur fracture. Subsequently, she had undergone left hemi-arthroplasty. Post operatively, she was managed with pain medication, intra venous fluid and antibiotics. During hospitalization, the patient was complained hip and back pain which was managed with hydrocodone and acetaminophen. The patient’s diuretic medications discontinued due to the complaints of hypotension and dizziness. She was commenced on physiotherapy sessions and assistance was provided for her daily activities. The patient has been complaining constipation since surgery. Therefore, she was commenced on Docusate 100mg daily and advised her to ambulate with a walker. It would be appreciated if you could assist Mrs XXX to complete her daily activities. Please monitor her physio sessions, medication intake and surgical site dressing. Please note, her staples to be removed on day 14 and her left lower extremity weight bearing is decreased to 30% for the next six weeks. The patient’s discharge medications are Hydrocodone 5mg, acetaminophen 325mg, Famotidine 20mg, Docusate100mg and Alendronate 10mg.

Referral letter I am writing to request further assessment and management of Mrs XXX. Her clinical signs and symptoms are suggestive of schizophrenia and associated disorders. Regarding Mrs XXXX’s social and medical history, she lives with her husband’s parents. The patient has a history of schizophrenia which was managed with Resperidone. Initially, Mrs XXX presented to the clinic on 09/01/2010 with complaints of poor health, tiredness, low grade fever and less energetic at work. She was advised regular exercise, relaxation therapy and to maintain a temperature chart. On Mrs XXX’s subsequent visit, she explained no changes in her previous symptoms. The patient mentioned anxiety, poor sleep, frequent head aches and difficulty to stay with her husband’s parents. Because, her mother in low complaining that she is lazy and trying to turn her husband against his mother. The patient was commenced on Diazepam 10 mg in the night and paracetamol whenever needed. She was counseled and advised her to maintain relaxation therapy. The patient was advised to revisit with her husband. Today, Mrs XXX represented to the clinic along with her husband. He mentioned that she follows less eye contact, poor speech, impaired planning and visual hallucination along with delusion for 5 days. During observation, she was depressed and mentioned less eye contact. It would be appreciated if you could further examine Mrs Martin and manage her symptoms symptomatically.

Referral letter I am writing to request continuity of care and management of Mrs XXX. She is being transferred to your facility today. Regarding Mrs XXX’s social and medical history, she lives alone. The patient is on anti-hypertensive medication Ramipril 10mg. On 04/02/2014, Mrs XXX was admitted to the hospital following a fall and she was diagnosed with left neck femur fracture. Subsequently, she had undergone left hemi-arthroplasty. Post operatively, the patient was transfused 3 units packed blood cells and maintained intra-venous therapy. The patient’s medication Ramipril dose decreased to 5 mg to manage hypotension. During hospitalization, Mrs XXX’s recovery was uneventful and her surgical drain tubes was removed on day 2. She is able to walk with pick-up frame and one-person assistance. An abduction pillow was provided during her rest period in bed and an anti-embolic stocking was applied to the patient for 14 days. Her surgical site alternate staples removed on day 5 and total assistance was provided to manage her daily activities. It would be appreciated if you could monitor Mrs XXX’s blood pressure twice in day for 3 days in a week. Please provide her paracetamol 1gm 6th hourly and whenever needed to manage pain. Please note, patient need to visit the hospital to recheck blood hemoglobin level and to remove remaining staples on day 8 and day 10 respectively. She can keep the wound open after staples remove. Kindly monitor her rehabilitation therapy.