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Your experience is important to us and helps us to make sure our services provide excellent care. If you have any comments or queries about our services please see our contact us section.

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Refer a patient

TIA fast track service referral

Referrer details
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GP details
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Patient details
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Gender: * required


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Reason for referral
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If symptoms occurred more than 14 days previously please refer to Dr Mamun's neurovascular clinic.

Previous stroke/TIA?: * required


If more than one TIA in past 7 days admit to hospital.

ABCD score for TIA: * required





Duration of symptoms: * required



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If weakness or speech disturbance not present. Referral will not be appropriate.

Monocular visual disturbance?: * required


Risk factors: * required








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Infection control status
MRSA * required



   
Recent history of vomiting or diarrhoea * required


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e.g. scabies, shingles (if none please enter None in this field)

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