Lokalt vårdprogram
Lokalt vårdprogram
Lokalt vårdprogram
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
AKTUALISERING<br />
Till: ______________________________________ Faxnr: ____________________<br />
Från: _____________________________________ Datum: ___________________<br />
Angående patient<br />
Namn: _________________________________ Personnr: _________________________<br />
Adress: ____________________________________________________<br />
____________________________________________________<br />
Tele: ____________________________<br />
Närmast anhörig / närstående: __________________________________________________<br />
Tele: ______________________________________________________________________<br />
Samtycke till information enligt nedan mellan specalistmottagning, primärvård och<br />
biståndshandläggare i kommunen.<br />
Patient JA NEJ<br />
Anhörig JA NEJ<br />
Underskrift: ……………………………………………………………………….<br />
Demensutredning pågår<br />
Demensdiagnos ja<br />
Ansvarig läkare: _____________________________________________<br />
Patientens/anhöriges önskemål:<br />
________________________________________________________________<br />
________________________________________________________________<br />
________________________________________________________________<br />
________________________________________________________________<br />
___________________________________________________________________________<br />
Genombrottsprojektet 2005<br />
Minnesmottagningen/PV/Kristianstads kommun<br />
46