North Staffordshire Local Medical Committee

EMIS DOCUMENTS

The EMIS computer system is used by about 70% of practices in North Staffordshire. A number of colleagues have produced documents which can be used within the referral module of the system. A collection of these can be downloaded from this page. To download right click over the document required and "save as" in the appropriate folder on your clinical system.

University Hospital of North Staffordshire Cancer Referral Forms

Please note these forms were updated in March 2006

Bone

Brain (updated May 06)

Brain - CT scan request

Breast

Colorectal

Gynaecology (amended June 06)

Haematology

Head and Neck

Lung (updated June 07)

Paediatrics

Skin

Upper GI

Urology

Other Documents

Doppler referral form for suspected DVT (July 07)

TIA Clinic (updated Nov 2005)

Physio Referral Form (Leek Moorlands Hospital)

School Nurse Referral Form

Drug Agreement (Generic)

Moorlands Community Addiction Service Referral Form

Epilepsy Clinic Referral Form

Douglas McMillan Home Services Referral Form

N S Palliative Care Communications Form

Access to Medical Records

Chest Pain Rapid Access Clinic (Modified June 04)

Chiropody Referral

Podiatry Referral (North Stoke PCT)

Dietetic Referral

Hearing Aid Referral

Private Sick Note - Letter for Employers

"Smashers" Referral Form

More Proforma will be added in due course. Thanks to Drs Mark Welton and Paul Bromley  for contributing some of these documents.

Inclusion of proforma on this site does not indicate formal LMC approval of these documents and their contents.