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Information Requested when Referring a
Physician for Assessment 

The following information may be requested from the referring agency at the time of a referral for assessment:

  • Reason for referral for assessment
  • Additional concerns (e.g., disruptive behavior, sexual misconduct issues)
  • Compliance timeframes mandated for assessment, including deadline (if any) for receipt of the assessment outcome report
  • Status of license and current practice
  • Status of investigation or action
  • Brief history of interactions(s) with referring entity
  • Known practice distractors or more global issues
  • Other markers and indicators (e.g., medical board actions, hospital actions, malpractice suits)