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    PT Referral 1

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    raad_alghamdi_1
    Fares Homoud al Otibi, a 67 year old Saudi male, has been referred by Dr. Mazen Haj Ahmad from the AL-Ekhaa Center at Eradh Complex of Mental Health to an ophthalmologist for evaluation and treatment of loss of vision. Mr. al Otibi has a history of chronic schizophrenia and is being treated with Olanzapine, Quetiapine, and Escitalopram. He has also been prescribed Atorvastatin and ASA. The referral notes that the patient's loss of vision has increased and requires an evaluation at the ophthalmology clinic for consultation and treatment.

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    PT Referral 1

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    raad_alghamdi_1
    25 views1 page
    Fares Homoud al Otibi, a 67 year old Saudi male, has been referred by Dr. Mazen Haj Ahmad from the AL-Ekhaa Center at Eradh Complex of Mental Health to an ophthalmologist for evaluation and treatment of loss of vision. Mr. al Otibi has a history of chronic schizophrenia and is being treated with Olanzapine, Quetiapine, and Escitalopram. He has also been prescribed Atorvastatin and ASA. The referral notes that the patient's loss of vision has increased and requires an evaluation at the ophthalmology clinic for consultation and treatment.

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    pt referral 1

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    Fares Homoud al Otibi, a 67 year old Saudi male, has been referred by Dr. Mazen Haj Ahmad from the AL-Ekhaa Center at Eradh Complex of Mental Health to an ophthalmologist for evaluation and treatment of loss of vision. Mr. al Otibi has a history of chronic schizophrenia and is being treated with Olanzapine, Quetiapine, and Escitalopram. He has also been prescribed Atorvastatin and ASA. The referral notes that the patient's loss of vision has increased and requires an evaluation at the ophthalmology clinic for consultation and treatment.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    25 views1 page

    PT Referral 1

    Uploaded by

    raad_alghamdi_1
    Fares Homoud al Otibi, a 67 year old Saudi male, has been referred by Dr. Mazen Haj Ahmad from the AL-Ekhaa Center at Eradh Complex of Mental Health to an ophthalmologist for evaluation and treatment of loss of vision. Mr. al Otibi has a history of chronic schizophrenia and is being treated with Olanzapine, Quetiapine, and Escitalopram. He has also been prescribed Atorvastatin and ASA. The referral notes that the patient's loss of vision has increased and requires an evaluation at the ophthalmology clinic for consultation and treatment.

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    Health Care No 902869 ‫الرقم الصحي‬

    Name Fares Homoud al Otibi ‫االسم‬


    Age 67 ‫العمر‬ Sex male ‫الجنس‬
    Nationality saudi ‫الجنسية‬
    ‫المملكة العربية السعودية‬ ‫االستشاري‬
    Consultant In-charge Eradh Complex of Mental Health ‫المسئول‬
    ‫وزارة الصحة‬

    ‫التجمع الصحي الثالث‬

    ‫مجمع ارادة والصحة النفسية بالرياض‬ .Dept INTERNAL ‫القسم‬ Unit ‫الوحدة‬

    ‫قسم أهلية العالج والتنسيق الطبي‬

    REFERRAL FORM ‫نـمــوذج تـحـــــويـــــــل‬


    TO DR OPHTHALMOLOGIST DEPT OPHTHALMOLOGY
    OPHTHALMOLOGY Hospital in
    DESIGNATION HOSPITAL / PHC
    Riyadh
    FROM DR AL-Ekhaa Center DEPT INTERNAL
    DESIGNATION HOSPITAL / PHC Eradh Complex of Mental Health

    Known patient with past history of chronic schizophrenia on :

    (1- OLANZAPINE 15 MG HS , 2- QUETIAPINE 50 MG OD ,3- ESCITALOPRAM 10 MG OD )

    & PUT ON : -ATORVASTATIN 20 MG OD , -ASA81 MG OD

    -the patient complains of loss vision and now his condition has increased , he needs evaluation in ophthalmo clinic

    And treatment …

    with full thanks.

    PATIENT'S CONDITION :  Critical Conscious  Unconscious


    REASON FOR REFERRAL :  CONSULTATION & TREATMENT Further Investigation
    Other : ADMISSION

    DOCUMENTS SENT :  Med.Report Lab.Result X_ray  Other:…………..


    Dr.'s Name MAZEN HAJ AHMAD
    Mobile # 0595603653

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