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BCWH Complex Chronic Disease Program Referral 2016

Created at the request of the Division of Family Practice of Chilliwack. There are several "extras". The date of referral comes originally as YYYY-MM-DD, however clicking on the input box, and clicking on "Today" in the calendar will give you today's date in DD-MM-YYYY format as requested on the form. The yes/no XBoxes are coded like radio buttons so that you cannot say both yes and no. Reason for referral pulls the medical history. There is a hidden link to the pdf map for BCWH. Click over Directions (entrance #77) - web instructions/map and you will jump to the pdf of the map. Page 2 was a discussion about the interpretation services, and this has been moved to a (non-printing) box beside the first page.

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