Educational only: This resource does not diagnose a condition, replace a clinician, or guarantee a Metro East Health service pathway. Use emergency services for urgent or life-threatening symptoms.
Referral source and callback
Include the organization, your role, direct phone, professional email, preferred response method, and the person who can answer follow-up questions.
Patient setting and location
Use initials on the public form, plus city or ZIP, current setting, expected discharge date if relevant, and whether home health, hospice, a facility, or caregivers are involved.
Clinical reason for referral
Identify the wound type, duration, current treatment, recent change, urgency, PCP status, and the outcome your team is trying to achieve.
Secure records pathway
Do not paste full records or attach images to a public website form. After intake review, use the secure method provided by the receiving team or fax when directed.