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Community IV Referral Form to ECCH

 ECCH Integrated Care Co-ordination Centre (ICCC) 01493 809977

Patient MUST already have a PICC line, Mid line or Cannula

 Patients to attend ECCH site with Medication Prescription chart, discharge summary and  a supply of the medicines

Patient Details

Referring Consultant
Proposed IV Therapy (1)
Proposed IV Therapy (2)
Proposed IV Therapy (3)

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