Home Health Reports User Guide - CPSI Application Documentation

Patient Functions Forms 132.4 Referral FormThe Referral Form is used by the nurse making the initial evaluation and future evaluation visits.How to PrintFrom the Home Health Base Menu, enter the desired patient account number.1. Select Referral Form.2. Select View on Screen or Send to Printer, and select appropriate laser printer if applicable.3. System prompts, "How Many?" Enter the desired number of copies to print.Description and UsageThe Home Health Referral Form provides information such as address information as well asdetailed directions to the patient's home. It lists unique problems suffered by the patient, thepatient’s attending physician, needed services, DME information, the referral source, thecaregiver, and the primary/secondary billing information.© 2014 Computer Programs and Systems, Inc.