Page 4 - Liver patient passport

Healthcare team

Use this page to list all relevant information
related to members of your healthcare team.

Complete the details below to ensure that your passport is returned to you
in the event that you lose it. It will also help healthcare team members to understand
the type of management that you are receiving for your condition.

Hospital name and
contact details

Consultant name
and contact details

I am on a transplant
waiting list Yes No

Transplant Centre name
and contact details

Transplant Coordinator
contact details

Team member Name and contact number

GP

Carer/Next of kin
Specialist nurse

Community nurse
Dietitian

Social worker

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