HMR Notice to Assess Form

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Getting Started

HMR Notice to Assess
The HMR Notice to assess form can be used to notify the Rochdale Home First Hospital Hub of planned discharges.

  • The form ensures a clear, timely, and consistent process to support safe discharges
  • Use the form as early as possible in discharge planning
  • The form replaces previous referral methods (e.g., ad hoc emails)
What you need to complete this form
You will be required to create a portal account, or log into an existing account, in order to complete and submit this form.
The form will ask you information about:

  • The patient you are referring
  • The patient's needs and requirements
  • The reason for the referral
  • Your details in case of follow up
How long will this take to complete

The form should take less than 15 minutes to complete.
Please be aware that for security reasons the session will time out after 20m of inactivity
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How to use this Form
Questions
You DO NOT need to answer every question, you need only complete what is relevant.
Select the option(s) that best suit your response This symbol indicates that the question is mandatory and must be answered in order to continue. image. Select the option(s) that best suit your response

This symbol Select the option(s) that best suit your response This symbol indicates that the question is mandatory and must be answered in order to continue. image. indicates that the question is mandatory and must be answered in order to continue.
Use the numbered menu items on the left or use the Use the numbered menu items on the left or use the and options to move through the pages. Don't use the Browser 'Back' button image. and Use the numbered menu items on the left or use the and options to move through the pages. Don't use the Browser 'Back' button image. options to move through the pages.

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