Online Referraltgoadmin2020-02-07T19:29:49+00:00 Name Date of Birth Telephone Referral to : Dr. Anh Huan Le MBBS BMEDSCI FRACP (Consultant Physician, Gastroenterologist, Hepatologist).Dr. Eu Jin Lim MBBS FRACP (Consultant Physician, Gastroenterologist, Hepatologist).Dr. Anne Kidman MBBS FRACP (Consultant Physician, Gastroenterologist, Hepatologist).Dr. Amir Safe MD (Bristol) FRCP FRACP (Consultant Physician, Gastroenterologist).Dr. Lucy Lim MBBS FRACP (Consultant Gastroenterologist and Hepatologist).Dr. Viet Pham BMBS FRACP (Gastroenterologist, Hepatologist).Mr. Niyaz Naqash MBBS MS FRACS (General & Laparoscopic Surgeon, Endoscopist).Dr. Qurat-Ul-Ain (Anny) Rizvi MBBS BMEDSCI FRACP(Gastroenterologist and Hepatologist ) Reason for Referral Consultation.Gastroscopy.Colonoscopy.Capsule Endoscopy. FOR COLONOSCOPY Previous colonoscopy YesNo Last colonoscopy (please attach details if known): Positive FOBTAbdominal pain/bloatingPR bleeding or mucus productionIron deficiencyUnexplained weight lossAnaemiaAbnormal imagingManagement of inflammatory bowel disease Recent change in bowel habits: constipationdiarrhoeatenesmuschange in frequency Family history of colon cancer: details: Previous colon polyps: details: Medical History Medications Diabetic:InsulinOralAnticoagulant/AntiplateletWarfarinClopidogrel/Prasugrel/TicagrelorRivaroxaban/Apixaban/Dabigtran Allergies Urgency Routine(1-2 weeks)Urgent REFERRING DOCTOR DETAILS Name Email Provider No Telephone Download SEC Referral Letter