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Primary Care Physician
15-20 minutes

Letter of Referral

This referral letter template from s10.ai is crafted for General Practitioners to seamlessly refer patients to specialists for advanced evaluation and management. It features sections for clinical details, past medical history, current medications, recent tests, and results, ensuring all pertinent information is conveyed clearly to the specialist. This template promotes a smooth transition of care, making it an ideal tool for streamlining the referral process. By providing specialists with comprehensive and organized patient information, it enhances clinical efficiency. Perfect for high-volume searches related to medical referral form templates and medical progress note examples, this template is a must-have for healthcare professionals looking to optimize their referral workflow.

2,340 uses
4.3/5.0
J
Jordan Patel
Template Structure

Organized sections for comprehensive clinical documentation

[s10.ai Letterhead]
[Date]
To:
[Consultant’s Name]
[Specialist Clinic/Hospital Name]
[Address Line 1]
[Address Line 2]
[City, Postcode]
Dear Dr. [Consultant’s Last Name],
Re: Referral for [Patient’s Name], [Date of Birth: DOB]
I am referring [Patient’s Name] to your clinic for further evaluation and management of [specific condition or concern].
Clinical Details:
Presenting Complaint: [e.g., Persistent abdominal pain, recurrent headaches] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
Duration: [e.g., Symptoms have been present for 6 months] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
Relevant Findings: [e.g., Significant weight loss, abnormal imaging findings] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
Past Medical History: [e.g., Hypertension, diabetes] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
Current Medications: [e.g., List of current medications] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
Investigations:
Recent Tests: [e.g., Blood tests, MRI, X-rays] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
Results: [e.g., Elevated liver enzymes, abnormal MRI findings] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
Reason for Referral:
Due to [e.g., worsening symptoms, need for specialized evaluation], I would appreciate your expert assessment and management recommendations for this patient.
Patient’s Contact Information:
Phone Number: [Patient’s Phone Number] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
Email Address: [Patient’s Email Address] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
Enclosed are [e.g., relevant test results, imaging reports] for your review. Please do not hesitate to contact me if you require further information.
Thank you for your attention to this referral. I look forward to your evaluation and recommendations.
Yours sincerely,
[Your Full Name] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
[Your Title] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
[Your Contact Information] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
[Your Practice Name] (only include if explicitly mentioned in the transcript, contextual notes or clinical note, otherwise leave blank.)
(Always write in full sentences and never use bullet points)
(Never come up with your own patient details, assessment, plan, interventions, evaluation, and plan for continuing care - use only the transcript, contextual notes or clinical note as a reference for the information include in your note. If any information related to a placeholder has not been explicitly mentioned in the transcript, contextual notes or clinical note, you must not state the information has not been explicitly mentioned in your output, just leave the relevant placeholder or section blank.)
Sample Clinical Note

Example of completed documentation using this template

[Your Practice Letterhead]
[Date]
To:  
Dr. Sarah Johnson  
Cardiology Department, St. Mary's Hospital  
123 Heart Lane  
Newtown, NT 45678
Dear Dr. Johnson,
Re: Referral for John Doe, Date of Birth: 01/01/1980
I am referring John Doe to your clinic for further evaluation and management of ongoing chest pain.
Clinical Details:  
Presenting Complaint: Ongoing chest pain  
Duration: Symptoms have persisted for 3 months  
Relevant Findings: Notable weight loss, irregular ECG results  
Past Medical History: Hypertension, diabetes  
Current Medications: Lisinopril, Metformin
Investigations:  
Recent Tests: Blood tests, ECG, Chest X-ray  
Results: Elevated troponin levels, irregular ECG results
Reason for Referral:  
Due to the aggravation of symptoms and the necessity for specialized evaluation, I would appreciate your expert assessment and management recommendations for this patient.
Patient’s Contact Information:  
Phone Number: 555-123-4567  
Email Address: johndoe@example.com
Enclosed are relevant test results and imaging reports for your review. Please do not hesitate to contact me if you require further information.
Thank you for your attention to this referral. I look forward to your evaluation and recommendations.
Yours sincerely,
Dr. Thomas Kelly  
General Practitioner  
555-987-6543  
s10.ai
Clinical Benefits

Key advantages of using this template in clinical practice

  • This comprehensive clinical referral template is designed to streamline communication between primary care providers and specialists, ensuring a seamless transition of care for patients requiring further evaluation and management. By incorporating high-search healthcare keywords, this template enhances clinical documentation efficiency and accuracy, facilitating the referral process for conditions such as persistent abdominal pain or recurrent headaches. Clinicians can easily customize sections to include pertinent patient information, such as past medical history, current medications, and recent test results, ensuring that specialists receive all necessary data for informed decision-making. Adopting this template can significantly improve patient outcomes by promoting timely and coordinated care, making it an essential tool for any healthcare practice looking to optimize their referral process.
Frequently Asked Questions

Common questions about this template and its usage

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Letter of Referral