Example Ambulance Care Summary for General Practices

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Advice of Ambulance Contact *** ATTENTION GP *** If this patient is not enrolled in your practice or if you believe you have received this information in error or for further information, please contact the St John Referrals Coordinator at referrals@stjohn.org.nz or by phoning 0800 ST JOHN (0800 473 876) and asking to speak to the Referrals Coordinator.

Doctor Proctor Taihape Health, 3 Hospital Rd, Taihape (06)388 0926

Patient Information NHI Number:

ZCJ7684

Name:

Anne Smith

Sex:

Female

DoB:

01/06/1968

Address:

18 Main Highway, Taihape, 4720, New Zealand

Age:

50

Year(s)

Incident Information Date and time of call

08/07/2018 06:16

Incident Location:

18 Main Highway, Taihape

Ambulance Master Incident Number:

0104-2-2018/07/08

Home

Location Type: ACS access code:

TP-RFA-KBZ-BE

ACC Claim Number:

Note to GP We recommended that Anne contacts your practice ASAP if her flu-like symptoms worsen.

Advice to Patient Family advised to phone ambulance back if Anne becomes difficult to rouse, cannot mobilise, develops a headache unrelieved with pain relief or develops a rash.

Advice to GP of Ambulance Contact

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ZCJ7684

Anne Smith 08/07/2018 06:16


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