Surgeon referral pathway

Pre-op & Post-op referral

Submit a structured referral for patients who may benefit from pre-operative optimisation or post-operative rehabilitation. The SOAR team will triage the patient and coordinate the right practitioner pathway.

Patient details

Patient name

Patient phone

Patient email

Date of birth

Surgical details

Referring surgeon

Referring practitioner email address

Practice / rooms

Referral type

Procedure

Planned surgery date

Hospital

Urgency

Referral focus

Medical optimisation Nutrition / weight optimisation Mobility / conditioning Pain optimisation Wound care referral Anxiety / emotional readiness Anaesthetic risk review Specialty infusion order (biologic / iron) Blood sample collection / pathology panel request

Clinical flags

Diabetes Smoking Anticoagulation Frailty concern Limited mobility Poor nutrition / weight concern Chronic pain Previous surgical complication

Medical Aid Information (if known)

Private / cash patient — patient does not have medical aid cover

Medical aid scheme name

Plan type

Main member full name

Main member ID number

Dependant code

Additional notes

ICD-10 codes / reason for referral

Clinical context / request

Preferred SOAR MDT member / pathway

Preferred patient contact

I confirm that the patient consents to SOAR Health Centre processing their personal and health information for referral, triage, and care coordination.

Referral details are stored securely and shared only with the SOAR clinical team and your referring practitioner for the purposes of arranging and delivering care. View our privacy notice.

Referral submitted

The patient has been added to the SOAR dashboard for pre-op triage. The team can now contact the patient and link them to the patient assessment.

SOAR Health Centre · BHF Practice No. 9990500001371908