UK Practice: 2nd Floor, 13-15 Bouverie Street, London, EC4Y 8DP, UK Company number 8614024 Tel: +44 (0)330

088 4980
ROI Practice: 25-28 North Wall Quay, IFSC, Dublin 1, Dublin, D01 H104, Ireland Company number 689685 Tel: +353 (0)1800 719 048
SHL_CLINICAL contactus@doctorcareanywhere.com

Onward Referral to In-

Person Specialist
(10/05/2024) 1/3

Patient details: Appointment details:

Name: Mr Bastin Navin Joseph Amalraj Ref number: APP-003287562
Address: 15 Artisan Place, London, HA3 5FB, United Kingdom Date & time: 10 May 2024, 19:40
Date of birth: 20 Jan 1981 (Age 43) Clinician: Dr Federica Gallenca
Phone: +44 (0) 7423133407 GMC: 7078630
Email: bastinnavin@gmail.com
DCA reference no.: DCA-001548373
Insurance member no.: Not Known

Disclaimer: Please be advised that this referral letter must not be used as a request for investigations. These might be blood tests or imaging
tests like x-rays. If this referral letter is used to request investigation(s) on behalf of a patient, then Doctor Care Anywhere cannot be held
responsible or liable for receiving or acting upon any results that come from these tests.

Referral service:
Post-diagnostics onward referral (same specialty)

Speciality:
Orthopaedics

Hip surgeon

Dear Colleague,

Thank you for seeing this patient who has consulted on the Doctor Care Anywhere platform today. Their history and consultation notes are
as follows:

Presenting complaint
Hip Pain

History of presenting complaint & examinations

Id confirmed - location - GP consent to share notes

2 years pain - had physio - getting worse - painful walking - not regular radiation of pain

Left side. History of trauma. Leg not shortened or rotated. Has not been in significant pain since this trauma. Recent history of strenuous or
repetitive activity. Able to weight bear.
Not walking with a limp. No Feverish symptoms. Movement of the joint is very painful. Pain is present at rest. No previous injury or surgery t
o the joint.

Seen well - discussed report from specialist and MRI scan showing mild insertional tendinosis related to the left hamstring musculature, min
or signal change related to the rectus femoris, iliopsoas and gluteus tendons bilaterally, subtle signal change within the left gluteus maximus,
minimal fluid in iliopsoas bursa bilaterally and patchy signal change related to the inferior aspect of the left sacroiliac joint -
[Continued overleaf]
 Not walking with a limp. No Feverish symptoms. Movement of the joint is very painful. Pain is present at rest. No previous injury or surgery t
o the joint.

UK Practice: 2nd Floor, 13-15 Bouverie Street, London, EC4Y 8DP, UK Company number 8614024 Tel: +44 (0)330 088 4980
Seen well - discussed report from specialist
ROI Practice: and Wall
25-28 North MRIQuay,
scan showing
IFSC, mild insertional
Dublin 1, Dublin, tendinosis
D01 H104, Ireland related
Company number to the
689685 Tel:left
+353hamstring musculature, min
(0)1800 719 048
or signal change related to the rectus femoris, iliopsoas and gluteus tendons bilaterally, subtle signal
SHL_CLINICAL change within the left gluteus maximus,
contactus@doctorcareanywhere.com

minimal fluid in iliopsoas bursa bilaterally and patchy signal change related to the inferior aspect of the left sacroiliac joint -
[Continued overleaf]

Onward Referral to In-

Person Specialist
(10/05/2024) 2/3

Patient details: Appointment details:

Name: Mr Bastin Navin Joseph Amalraj Ref number: APP-003287562
Address: 15 Artisan Place, London, HA3 5FB, United Kingdom Date & time: 10 May 2024, 19:40
Date of birth: 20 Jan 1981 (Age 43) Clinician: Dr Federica Gallenca
Phone: +44 (0) 7423133407 GMC: 7078630
Email: bastinnavin@gmail.com
DCA reference no.: DCA-001548373
Insurance member no.: Not Known

Disclaimer: Please be advised that this referral letter must not be used as a request for investigations. These might be blood tests or imaging
tests like x-rays. If this referral letter is used to request investigation(s) on behalf of a patient, then Doctor Care Anywhere cannot be held
responsible or liable for receiving or acting upon any results that come from these tests.

Continued

Patient is currently not having pain killers - advised OTC medications if needed- stated avoidance behaviour - not exercising - nil radiation -
discussed referral

Past medical history

Hip Pain

Medications
Nil

Allergies
No Known Drug Allergies

Family history
not discussed
[Continued overleaf]
 UK Practice: 2nd Floor, 13-15 Bouverie Street, London, EC4Y 8DP, UK Company number 8614024 Tel: +44 (0)330 088 4980
ROI Practice: 25-28 North Wall Quay, IFSC, Dublin 1, Dublin, D01 H104, Ireland Company number 689685 Tel: +353 (0)1800 719 048
SHL_CLINICAL contactus@doctorcareanywhere.com

Onward Referral to In-

Person Specialist
(10/05/2024) 3/3

Patient details: Appointment details:

Name: Mr Bastin Navin Joseph Amalraj Ref number: APP-003287562
Address: 15 Artisan Place, London, HA3 5FB, United Kingdom Date & time: 10 May 2024, 19:40
Date of birth: 20 Jan 1981 (Age 43) Clinician: Dr Federica Gallenca
Phone: +44 (0) 7423133407 GMC: 7078630
Email: bastinnavin@gmail.com
DCA reference no.: DCA-001548373
Insurance member no.: Not Known

Disclaimer: Please be advised that this referral letter must not be used as a request for investigations. These might be blood tests or imaging
tests like x-rays. If this referral letter is used to request investigation(s) on behalf of a patient, then Doctor Care Anywhere cannot be held
responsible or liable for receiving or acting upon any results that come from these tests.

Continued

Suspected Diagnosis
Hip Pain

Recommended actions
advised about OTC medications and review with specialist - in case of changes of pain - to contact clinician

Notes to your GP
None added

I would appreciate your review of this patient given the history and ongoing symptoms.
Many thanks

Yours sincerely,
Dr Federica Gallenca

Please also copy any further correspondence to the patient's GP

Dr Federica Gallenca ( GMC: 7078630 )

Signature:

Dr Tim Bray, MRCGP is the accountable GP, Chief Medical Officer and CQC registered Manager of this referral.