[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-166014-en":3,"doc-seo-166014-105":29,"detail-sidebar-cat-1-en-105":89},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":11,"category_id":12,"category_name":13,"doc_title":14,"doc_description":15,"doc_content":16,"file_id":17,"file_url":18,"file_type":19,"file_size":20,"view_count":4,"is_deleted":4,"is_public":11,"is_downloadable":11,"audit_status":11,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":15,"update_tm":28,"read_time":11},166014,687197100911,"Himbo","https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697",1,17,"Forms","Referral Template - FINAL NEW","This document contains a referral template for suspected axial spondyloarthritis or ankylosing spondylitis. It includes fields for referral details, GP practice information, and patient demographics. The template lists specific symptoms and clinical features that may indicate the condition, such as insidious onset of back pain, age of onset, improvement with activity, and presence of enthesitis, dactylitis, psoriasis, uveitis, or inflammatory bowel disease. It references the NICE Guideline for Spondyloarthritis, outlining criteria for referral to a rheumatologist based on the number of present criteria and the result of an HLA-B27 test. The template also notes the enclosure of the SPADE Assessment Tool to support the findings and requests consideration for rheumatology referral for further diagnostic evaluation. The document is signed off with a professional closing.","Referral details\nReferral Date:\t\t\t\t\tReferred by:\nGP Practice Details:\nPatient Details\nName:\t\t\t\t\t\t\t\t\tDate of Birth:\nAddress:\nI have assessed the above named patient and suspect that they may have axial spondyloarthritis or ankylosing spondylitis as they have exhibited the following symptoms and/or clinical features:\n\u0003☐\u0004 Insidious onset of back pain for longer than 3 months\n\u0003☐\u0004 Age at onset of back pain less than 40 years\n\u0003☐\u0004 Improvement of back pain with activity\n\u0003☐\u0004 No improvement of back pain with rest\n\u0003☐\u0004 Back pain at night resulting in disturbed sleep\n\u0003☐\u0004 Buttock pain which can alternate\n\u0003☐\u0004 Enthesitis\n\u0003☐\u0004 Dactylitis\n\u0003☐\u0004 Family history of spondyloarthritis\n\u0003☐\u0004 Psoriasis\n\u0003☐\u0004 Uveitis\n\u0003☐\u0004 Inflammatory bowel disease\nThe NICE Guideline for Spondyloarthritis states: If a person has low back pain that started before the age of 45 years and has lasted for longer than 3 months, refer the person to a rheumatologist for a spondyloarthritis assessment if 4 or more of the (above) criteria are also present. If exactly 3 of the additional criteria are present, perform an HLA-B27 test. If the test is positive, refer the person to a rheumatologist for a spondyloarthritis assessment.\nI have also enclosed a copy of the SPADE Assessment Tool which supports my findings. I would therefore be grateful if you could please consider referring this patient into rheumatology for further evaluation of the diagnosis.\nYours sincerely,","cbCaitEFzGGKoFDl","https://ap.wps.com/l/cbCaitEFzGGKoFDl","docx",80837,2,"English","en",105,"# Referral Details\n# Patient Details\n# Referral Criteria\n# Enclosed Documents\n# Conclusion","[{\"question\":\"What is the purpose of this referral template?\",\"answer\":\"This referral template is used to document suspected cases of axial spondyloarthritis or ankylosing spondylitis and to guide referral to a rheumatologist for further evaluation.\"},{\"question\":\"What are the key symptoms that suggest axial spondyloarthritis or ankylosing spondylitis according to this template?\",\"answer\":\"Key symptoms include insidious onset of back pain lasting longer than 3 months, onset before age 40, improvement with activity but not rest, nocturnal pain, buttock pain, enthesitis, dactylitis, and a family history of spondyloarthritis, among others.\"},{\"question\":\"What guidance does the NICE Guideline provide for referral?\",\"answer\":\"The NICE Guideline suggests referring a patient to a rheumatologist if they have low back pain starting before age 45 and lasting more than 3 months, along with 4 or more of the specified criteria. If 3 additional criteria are present, an HLA-B27 test is recommended, with referral if positive.\"}]","Referral Template - FINAL NEW | DOCX",1788181084,{"code":4,"msg":30,"data":31},"ok",{"site_id":24,"language":23,"slug":32,"title":14,"keywords":33,"description":15,"schema_data":34,"social_meta":84,"head_meta":86,"extra_data":88,"updated_unix":28},"referral-template-final-new","",{"@graph":35,"@context":83},[36,52,66],{"@type":37,"itemListElement":38},"BreadcrumbList",[39,43,46,49],{"item":40,"name":41,"@type":42,"position":11},"https://docshare.wps.com","Home","ListItem",{"item":44,"name":45,"@type":42,"position":21},"https://docshare.wps.com/template/","Template",{"item":47,"name":13,"@type":42,"position":48},"https://docshare.wps.com/template/forms/",3,{"item":50,"name":14,"@type":42,"position":51},"https://docshare.wps.com/template/referral-template-final-new/166014/",4,{"url":50,"name":14,"@type":53,"author":54,"headline":14,"publisher":56,"fileFormat":59,"inLanguage":23,"description":15,"dateModified":60,"datePublished":60,"encodingFormat":59,"isAccessibleForFree":61,"interactionStatistic":62},"DigitalDocument",{"name":9,"@type":55},"Person",{"url":40,"name":57,"@type":58},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-08-31",true,{"@type":63,"interactionType":64,"userInteractionCount":4},"InteractionCounter",{"@type":65},"ViewAction",{"@type":67,"mainEntity":68},"FAQPage",[69,75,79],{"name":70,"@type":71,"acceptedAnswer":72},"What is the purpose of this referral template?","Question",{"text":73,"@type":74},"This referral template is used to document suspected cases of axial spondyloarthritis or ankylosing spondylitis and to guide referral to a rheumatologist for further evaluation.","Answer",{"name":76,"@type":71,"acceptedAnswer":77},"What are the key symptoms that suggest axial spondyloarthritis or ankylosing spondylitis according to this template?",{"text":78,"@type":74},"Key symptoms include insidious onset of back pain lasting longer than 3 months, onset before age 40, improvement with activity but not rest, nocturnal pain, buttock pain, enthesitis, dactylitis, and a family history of spondyloarthritis, among others.",{"name":80,"@type":71,"acceptedAnswer":81},"What guidance does the NICE Guideline provide for referral?",{"text":82,"@type":74},"The NICE Guideline suggests referring a patient to a rheumatologist if they have low back pain starting before age 45 and lasting more than 3 months, along with 4 or more of the specified criteria. If 3 additional criteria are present, an HLA-B27 test is recommended, with referral if positive.","https://schema.org",{"og:url":50,"og:type":85,"og:title":14,"og:site_name":57,"og:description":15},"article",{"robots":87,"canonical":50},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":90},[91,96,101,106,111,116,119,124,129],{"id":92,"doc_module":11,"doc_module_name":45,"category_name":93,"show_sort_weight":94,"slug":95},11,"Presentations",90,"presentations",{"id":97,"doc_module":11,"doc_module_name":45,"category_name":98,"show_sort_weight":99,"slug":100},12,"Resumes",80,"resumes",{"id":102,"doc_module":11,"doc_module_name":45,"category_name":103,"show_sort_weight":104,"slug":105},14,"Invoices",70,"invoices",{"id":107,"doc_module":11,"doc_module_name":45,"category_name":108,"show_sort_weight":109,"slug":110},15,"Posters",60,"posters",{"id":112,"doc_module":11,"doc_module_name":45,"category_name":113,"show_sort_weight":114,"slug":115},16,"Social Media",50,"social-media",{"id":12,"doc_module":11,"doc_module_name":45,"category_name":13,"show_sort_weight":117,"slug":118},40,"forms",{"id":120,"doc_module":11,"doc_module_name":45,"category_name":121,"show_sort_weight":122,"slug":123},18,"Letters",30,"letters",{"id":125,"doc_module":11,"doc_module_name":45,"category_name":126,"show_sort_weight":127,"slug":128},21,"Paper Templates",5,"papers-templates",{"id":130,"doc_module":11,"doc_module_name":45,"category_name":131,"show_sort_weight":4,"slug":132},158,"General","general-158"]