Eastern Liver Network
EASTERN HEPATITIS NETWORK CENTRAL MDT REFERRAL DOCUMENTTreatment CentreClick here to enter text.Responsible ConsultantClick here to enter text.Clinical Nurse SpecialistClick here to enter text.Direct telephone no.Click here to enter text.NHS emailClick here to enter text.Patient NameClick here to enter text.GP practice/codeClick here to enter text.AddressClick here to enter text.NHS numberClick here to enter text.Hospital numberClick here to enter text.Date of BirthClick here to enter text.HCV genotype (inc date)SelectViral loadClick here to enter text.Fibroscan scoreClick here to enter text.BiopsyClick here to enter text.Other evidence of cirrhosisClick here to enter text.Co-morbiditiesClick here to enter text.Medications listClick here to enter text.WeightClick here to enter text.Issues for discussion at MDTClick here to enter text.Central MDT discussionClick here to enter text.Treatment recommendation:Click here to enter text.Please email completed document to add-tr.hepatitis@ ................
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