Patto territoriale - ASL Lecco
Patto territoriale - ASL Lecco
Patto territoriale - ASL Lecco
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OSPEDALE DI LECCO<br />
AZIENDA OSPEDALIERA<br />
PROVINCIALE DEL S.S.N.<br />
RELAZIONE CLINICA AL MEDICO CURANTE<br />
MOD. DL 17.4a<br />
REV.000<br />
Al / Alla Dott._________________________________________________________________________________<br />
Il/la Sig./Sig.ra _______________________________________________________________________________<br />
Visitato/a presso il nostro C.P.S. in data_________________________________________________________<br />
con diagnosi ___________________________________________________________________________________<br />
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Viene affidato/a al Curante Presa in cura per un periodo di mesi……….<br />
E’ previsto un approfondimento diagnostico Invio presso altra Agenzia<br />
Progetto terapeutico Integrato /Consiglio Terapeutico_______________________________________________<br />
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Controllo previsto per il giorno:___________________________________<br />
Richiederei la Sua collaborazione per:<br />
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Sono a Sua disposizione per un contatto telefonico il dalle alle<br />
Data______________________<br />
Timbro e Firma<br />
Centro Psicosociale di <strong>Lecco</strong>- Sede operativa di <strong>Lecco</strong>, Via Ghislanzoni, 22 –23900 <strong>Lecco</strong> .Tel. 0341 489181