Myalgic Enceohalomyelitis/Chronic Fatigue Syndrome Application Form

Myalgic Enceohalomyelitis/Chronic Fatigue Syndrome Application Form

Filename: MYALGIC-ENCEPHALOMYELITIS-CHRONIC-FATIGUE-SYNDROME-REFERRAL-FORM.DOCX

Tip fișier: DOCX

Dimensiunea fișierului: 494 Ko

Descărcare

If your patient falls within the Criteria Based Access element of the policy and the patient demonstrably meets the specific criteria for treatment, the patient can be referred directly via the appropriate Referral Service with the completed referral form.