UF Health Fax Numbers

Attachment:   img-190922141653-0001.pdf  (0.51 MB)

Correct Patient Chart Link

1) Select Patient Chart Link as shown

Order Labs: Please see an officer. Labs are ordered in a separate system by officers.

Your patient should be urgently evaluated in the Emergency Department.

Your patient appears to require urgent evaluation and diagnosis that we are not able to provide at any of our clinics. If for some reason this does not describe your patient and both your attending & an officer agree that this patient does not require urgent evaluation but could benefit from cardiology evaluation in the coming months, an officer can enter their password below to continue.

Diagnostic Testing Needed Prior to Referral

Your patient needs diagnostic testing ordered (holter monitor, stress test, etc) and resulted prior to referral to cardiology night. Please utilize the out of network referral navigator below and discuss with an officer how to order these tests.

If these tests have already resulted and are uploaded to Practice Fusion, please see an officer, and after they confirm the patient is eligible for a referral, they can approve this referral by entering their password here.

Who to Refer:

Services offered:

Benefits to Patients

Clinic Location and Times:

WeCare Dental Resources

Your patient does NOT appear to be eligible for a referral to dermatology.

Equal Access Clinic Women's Night

Who to Refer:

Services offered:

Clinic Location and Times:

Pap smears and other general women's health are provided at our Eastside and Main Street primary care clinics and are NOT eligible for a refer to Women's Night.

We are currently unable to provide colposcopies, LEEP, and other complicated procedures at our network's Women's Night. Instead, the patient should be referred to a community provider through a network such as WeCare.

EACN does not provide obstetric services for pregnant women. Instead, we work to connect them with insurance and a regular OB provider.

Who to Refer:

Services offered:

Clinic Location and Times:

Who to Refer:

Adults with significant vision loss, diabetics who have not been connected to eye care, and patients with a history of glaucoma.

Services offered:

• Complete Exams: IOP (interocular pressure) measurements, slit lamp exams, dilated fundus exams


• Screening: for cataracts, diabetic eye disease, glaucoma, retinal disease


• Work-up: for acute eye problems (pain, vision change, trauma, etc)


• Referral: to WeCare, Shands Charity Care


• We do NOT offer refractions for glasses or contact lenses.

Clinic Location and Times:

• When: Last Tuesday of each month, patients to arrive at 5:00 PM, patients are seen starting at 5:30 PM


• Where: HealthStreet at 2401 SE Archer Rd, Gainesville, FL 32608

Who to Refer:

Services offered:

Clinic Location and Times:

Services Offered

• Free Physical Therapy services to people unable to afford treatment elsewhere.


• Provide Physical Therapy evaluation and treatment, follow-up treatment visits, blood pressure and strength/flexibility screenings, referrals to specialists, and emergency medical referrals.


• Treat everyone in need of therapy care including; recent injury, postsurgical, preventative care, etc. - CANNOT treat peds patients


• Please fill out the PT referral form and provide to the patient to bring to clinic. (They can still be seen without it, but only for one month)

Clinic Location and Times:

We accept walk-in patients every Thursday from 6pm-8pm (excluding University holidays).

1621 SW 13th Street, above the CVS

Unfortunately, we do not yet have psychiatry services within EACN, nor does WeCare accept referrals for Psychiatry.

We can refer patients to the following local psychiatry services. See a clinic officer for a handout you can give patients.

Who to Refer:

Services offered:

Clinic Location and Times:

UF Health Social Work

Located on the third floor of UF Health Med Plaza in the lobby of Medical Specialities.
Patients can walk in from 8am-4:30pm.

See our pharmacy team to place a referral.

Who to Refer:

Services offered:

Clinic Location and Times:

Important Information for your Patient's Prep

Important Information for your Patient's Prep

Screening Mammogram Instructions

Ask an officer for this printed form and fill it out with a patient.

Officers, return the form to the interns to be faxed to the number on the form (NOT WeCare).

Out of Network Referral Options

We do not offer the specialty or test that you are requesting for your patient at this time, however after answering the following questions, you will be prompted to submit a referral to the appropriate local resource.

WeCare Eligible

Please ensure the submission form includes the patient's ICD-10 diagnosis code.

WeCare Officer Submission Instructions

Print and fill out the following forms:

• We Care – Fax Cover Sheet


• We Care - Patient Referral and Information
  
  
  
  • Note: the last 4 of the SSN must be included on the form for the referral to be processed.
    The form must also be signed by the attending physician.
  
  
  • Be sure to include an ICD-10 diagnosis code on the referral.
  
  
  
  


• Additional Forms Speciality-Specific Forms
  
  
  
  • We Care – Radiology Consult Order Form (Chest/Skeletal Plain Film)
  
  
  • We Care – Radiology Consult Order Form (CT/US/MRI/Nuclear Medicine)
  
  
  • We Care – Radiology Consult Order Form (Fluoroscopy/Mammography)
  
  
  • We Care – Diagnostic Cardiology Order Form
  
  
  • We Care – Diagnostic Pulmonology Order Form
  
  
  • We Care – Pathology Lab Order Form
  
  
  • We Care – Rheumatology Referral Form
  
  
  
  

Example:

Instruct patient about what to expect with We Care

• Hand patient a "We Care Info for Patients" sheet / (Spanish Version)


• Inform patient that We Care will call them within 1-2 weeks and inform them if they are eligible - if they do not hear from them in this time, call the number on the sheet.


• If eligible, We Care will give them additional instructions about how to proceed.


• After completion of this step all of the necessary information from the patient has been obtained and the patient may leave.

UF Health Financial Assistance Program Officer Instructions

A1C/Glucose: Speak with the pharmacy team to have this test done.

Make sure to leave this option selected so we can keep track of the number of tests completed.

Order FIT Test: You can pick up a FIT testing kit from a clinic officer.

Discuss with the patient these instructions and ensure this form is returned to a clinic officer.

EKG/HIV/Pregnancy/Strep/Urinalysis: Speak with an officer to have this test done.

Make sure to leave this option selected so we can keep track of the number of tests completed.

Speak with an officer to get the pap smear supplies, then complete the following information.

  If you are even thinking about a Baker Act, 

 please see an officer immediately.  

Leave this option checked upon submitting if a Baker Act was submitted.

A clinic director needs to notified immediately if you are implementing this protocol.

Please call another director if yours is unavailable.

Overview of Protocol

1. Patient tells medical or undergraduate student that they are a threat to themselves or others. 


2. Medical student or undergraduate student IMMEDIATELY notifies site officer or attending. 
   
   
   
   • Attending is IMMEDIATELY notified and takes lead over the rest of the visit
   
   
   • Medical student or HOQI volunteer waits outside patient room and if patient attempts to leave, student tells patient we would still like to speak with them and asks them to stay but does not attempt to physically restrain the patient if they decide to leave.
   
   
   • Medical student officer provides attending with copy of State of Florida Baker Act form and remains available to attending
   
   
   
   


3. Attending conducts a through evaluation of the patient (inquires about suicidal thoughts, plans, behaviors, and completes a full psychiatric ROS) and feels as though the patient is a threat to themselves or others with an active plan. 


4. Attending expresses concern about patient and offers them voluntary commitment.


5. Patient refuses voluntary commitment. 


6. Attending completes Baker Act Form --> see below to determine where GPD should transport pt

7. Medical student or HOQI volunteer remains with patient, preferably in the room, and if they attempt to leave inform them that they have been placed under an involuntary commitment and must stay. Do not attempt to physically restrain the patient and instead inform them that if they leave GPD will come looking for them.

8. Photo copy Baker Form, upload to PF chart after faxing it as above, and provide original to GP

9. Police arrive and form goes with patient and police

10. Document the encounter, including above sections

***How do we transport a patient to a facility for voluntary commitment?

• Unfortunately, there is not a good way to do this and ultimately a Baker Act Form must be signed to get them transported by police. Call 911 and tell them that they are voluntary, but need transport. When police arrive, remind them and ask the patient not be restrained/handcuffed.

What should I do if the patient leaves after seeing the attending?

• If the attending felt as though the patient met Baker Act criteria, they can sign the Baker Act Form and call 911. The police will collect them.

What should I do if the patient expresses SI/HI to a HOQI or medical student and leaves before an attending sees them?

• The HOQI or student should notify the attending immediately so that they can weigh in on how severe the statement was. However, an attending cannot sign a Baker Act Form for a patient they did not evaluate. Instead, if the attending agrees, call the police and explain the situation and ask for a safety check on the patient.

What should I do if I feel uncomfortable with examining the patient?

• Don't examine them! That's okay. Just document what you can see and mental status exam if applicable.

Last updated: June 2019

Sources used include: https://www.myflfamilies.com/service-programs/samh/crisis-services/laws/bainvex.pdf

https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.53.9.1171

https://www.myflfamilies.com/service-programs/samh/crisis-services/laws/BakerActManual.pdf

Patient Release Form

Please obtain our medical records release form from a clinic officer.

You only need to print and fill out the second page with the patient. The release PHI from section should include the name of the clinic we are requesting records from and the release PHI to section should state "UF Equal Access Clinic" with the fax number 352-627-4141.

Give the completed and signed form to a clinic officer, who will ensure it gets to our office staff for faxing.

Gender Affirming Therapy Protocol for Women

Gender Affirming Therapy Protocol for Men

Masculinization Labs

Please see an officer to order the following labs:

• CBC without diff (Hg and Hct for erythropoietic effect)


• Serum Estradiol (not total estradiol)


• Serum Total Testosterone LC/MS/MS (free testosterone unreliable [33]


• Serum Albumin

These labs should ordered and completed at least one full week prior to clinic visit (these labs are sent across the country and take awhile for Quest to process). We typically order labs at each visit for the follow up visit.

Feminizing Labs

Please see an officer to order the following labs:

• Serum Estradiol (NOT TOTAL estradiol)


• Serum TOTAL testosterone LC/MS/MS


• CMP

These labs should ordered and completed at least one full week prior to clinic visit (these labs are sent across the country and take awhile for Quest to process). We typically order labs at each visit for the follow up visit.

Therapeutic Lab Levels

Please review the patient's most recent labs and enter them here for follow up.

     READY FOR SUBMISSION    

Please press submit to finalize your submission.

Please contact a clinic officer if you need to change anything previously submitted.