IWMDS Referral

Intro

Note: Questions marked by * are mandatory


PRE-REFERRAL DETAILS (MUST BE PROVIDED IN ALL CASES) Please fill in as much detail as possible This referral will be reviewed by the IWMD Team and we aim to let you know about the possible outcome This referral is not for any acute or emergency clinical issues, if you think there is something urgent you need to discuss then please call the On Call Neurology Team
Nature of Referral: Review by IWMD MDT

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