Reason for referral (as received)
38F chronic migraine 12 days/month, failed topiramate and propranolol. Headache clinic referral for CGRP therapy. Med history attached. Cigna.
Extracted fields are AI-suggested from the de-identified text and require clinician confirmation ·
0 identifiers tokenized before AI · OCR/source: internal
Recommended destination
Headache clinic
Routing confidence
Missing to complete triage
Patient date of birthImaging report referenced or attachedInsurance / authorization infoReferring office callback numberCurrent medication list
Status
Status changes are staff actions — the referring office sees them, ending the fax black hole.
DRAFT — AWAITING STAFF APPROVAL BEFORE SEND
Missing-information request to referring office
Re: Referral NR-48211 — additional records needed to complete triage
We received your neurology referral. To complete clinical triage and route this to the correct headache clinic slot, please provide:
• Patient date of birth
• Imaging report referenced or attached
• Insurance / authorization info
• Referring office callback number
• Current medication list
Once received, we expect to confirm the appointment within 2 business days. If symptoms worsen before then, please direct the patient to the nearest emergency department.
— Referral Coordination