Get Alberta Health Services Srop 2016-2026

Completing the Alberta Health Services Specialized Rehabilitation Outpatient Program (SROP) online can streamline the referral process and ensure that all necessary information is accurately conveyed. This guide provides clear, step-by-step instructions to assist you in filling out the form effectively.

Follow the steps to complete your SROP referral form online

1. Click the ‘Get Form’ button to access the SROP referral form and open it in your preferred editor.
2. Begin by entering patient information. Fill in the last name, first name, middle name, street address, city, province, home phone, work phone, cell phone, date of birth, and the Personal Health Number (PHN).
3. Provide alternate contact information if applicable. Indicate whether the person requires an interpreter and their living situation. Specify the reason for referral clearly.
4. Document any pertinent medical history or most responsible diagnosis. Include any medical or activity restrictions, such as cardiac concerns, and list any known allergies.
5. Identify community supports involved in the patient's care, such as home care, day programs, or case managers, and provide their contact information.
6. Fill in the details of the referring physician or nurse practitioner, including their name, phone number, and fax number. Specify whether this referral source requires a copy of the discharge summary.
7. Outline the services requested by checking all applicable options, such as dietician, occupational therapist, or other rehabilitation services.
8. Answer questions related to the patient's past rehabilitation services over the last three months and indicate whether the patient has significant rehabilitation potential.
9. Document any falls experienced by the patient in the past year, including details on balance issues and walking difficulties.
10. Attach any requested documents available, such as discharge summaries or interdisciplinary assessments, ensuring not to send information from NetCare.
11. Record any referrals made to other physicians, including the date, time, physician name, and service or program involved.
12. Complete sections on cognitive impairment, communication issues, and any relevant behavioral aspects that may affect rehabilitation.
13. Evaluate basic activities of daily living, selecting the appropriate assistance level for self-care, transfer, ambulation, and mobility aids.
14. Conclude by entering comments that may include additional relevant details, and ensure to fill in the referral form completed by section with your printed name, signature, contact number, and date.
15. After verifying all information is accurate, save your changes, download or print a copy of the completed form, and share it as necessary.

Begin your referral process today by completing the SROP online.