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Tissue Viability

Tissue Viability eReferrals

Patient Details
Patient Details
Information Sharing
Optional Attachment
Optional Attachment
(Optional) - Please attach any clinical letters/any other relevant information
Referrer Details
Referrer Details
Wound Assessment
Wound Assessment
Submit
If you do not get redirected to a confirmation screen summarising what you have submitted the referral has not been sent. Please check that all details are correct, mandatory fields completed and re-submit. If you wish to save your answers for evidence, please save the page as a PDF.

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