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  QUICK REFERRAL

  Referral is easy. Please contact us using the form below. We will respond within 2 days setting out the options for referral, including whether the patient is eligible to be covered by any DHB funding, according to our contracts.

  Referrer:

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  Referrers Address:

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  Referrers Email:

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  Patient Name:

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  Patient NHI Number:

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  Patient DOB: Sex M/F: MF

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  Ethnicity:

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  Main Diagnosis:

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  Why the patient needs QE:

  Rheumatology Specialist
  Physiotherapy
  Occupational Therapy
  Orthotics
  Psych/Counselling
  Spa
  

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  Comorbilities, allergies:

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  Additional Info:

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QE Health’s intensive inpatient programmes are designed for patients for whom nothing else has worked.

QE Health’s intensive inpatient programmes are designed for patients who have not responded to regional pain management and rehabilitation programmes.

Most patients with arthritis and other chronic conditions are well managed in regional centres with outpatient medical treatment and education programmes. However, a small proportion of patients with arthritis and other chronic conditions still have difficulty managing their condition despite the best efforts of regional care services.

The patient struggles mentally and physically with the impact the chronic condition has on their life. Their loss in wellbeing is often associated with a loss of self confidence.

QE Health’s rehabilitation programme is unique in that it is created to work with these patients. Education is our focus. We provide an intensive inpatient programme of 1 - 3 weeks. Programme content depends on individual patient need but all programmes are aimed at helping the patient regain control and management of their lives.

We offer rehabilitation programmes for the following patients:

PROGRAMME AND ACCOMMODATION FEES as at 1 October 2010 [incl. GST]

Full Programme        $353.00 per day – for day patient
 
This Includes:
·    At least 4 hours per day
·    Lunch
·    Designated area to rest during day
·    Monday to Friday inclusive   

Additional costs that may be incurred:
·    Rheumatology consultation $256.00
·    Xrays, scans, bone density scan
·    Orthotics
·    Blood tests     

Accommodation Options

QE HEALTH
 
Wallis Wing
Private room with en suite                          $154.00 per night       
Wallis Wing + Ward 3
Private room with shared ablution facilities    $98.00 per night       
Ward 3
Shared ablution facilities plus nursing care     $98.00 per night      

MOTEL OR OTHER
Range of external accommodation choices – can be supplied on request.    Range of daily rates dependent on accommodation preferred.