MMH Neurology Inpatient Consult Request
Today is Feb 06, 2012 01:16
Dr. Kofahi (Direct line 270-2397)
is on call for Neurology.
Please complete this form to make inpatient referrals to our practice.
Please ask the referring physician to also call directly for consults that
are Stat or require immediate attention. You may also use to send
a text message to the On Call Neurologist.
Your Name:
Your Phone Number (10 digit):
Referring Doctor:
Patient Name (Last, First):
Unit and Room Number:
Patient Date of Birth:
Reason for Consult:
Check if entered into McKesson?:
Yes
Text message will be sent to Office Staff and to Dr. Kofahi
Click for KGH Neurologist On Call
Click for Outpatient Neurology Referrals
Click for Main On Call & Referral Page
