There is a box that lists actors without definitions - assume these are the same as in section 5 (suggest linking there).  But then in the overall diagram, these actors are not referenced and instead Referral Source, Referral Recipient, Intermediary, and Patient/Client are listed.  Each of these actors (the stick figures) need to be defined and tied to the Actors listed in the boxes above it.  The diagram is confusing especially because bidirectional arrows are used.  I see that patient instructions seem to be flowing in both directions.  Was also surprised not to see Patient Instructions in the Patient flow diagram later on, assuming this overall diagram is a summary.  In some parts of section 9 it refers to referrals such as "cancel a referral" and other places it refers to services.  Do these mean the same thing?  If so, please be consistent or else explain how they are different.  

Section 9 is helpful but confusing.