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General Practitioner Template

Radiology referral

A professional General Practitioner template for healthcare professionals.
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Specialty

General Practitioner

Used

12 times

Type

Note

Last edited

2026/04/13

Created by

William Gordon-Wright

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About this template

Need a clear and concise way to request imaging for your patients? This Radiology Referral template is perfect for General Practitioners. It helps you document the patient's history, symptoms, and clinical findings, ensuring all necessary information is included for the radiologist. This template streamlines the referral process, making it easier to request the appropriate imaging studies. It's designed to capture the essential details needed for an effective referral, saving you time and improving communication with radiology departments. This template is ideal for GPs looking to improve their referral documentation.

Preview template

Patient: Mrs. Eleanor Vance, [insert age] 68 years old. History: Presents with a 2-week history of worsening right hip pain, exacerbated by weight-bearing and activity. No history of trauma. Previous episodes of similar pain, but this is the most severe. Symptoms: Right hip pain, described as aching and throbbing. Pain radiates to the groin and occasionally down the anterior thigh. Reports stiffness in the morning. Clinical Findings: Limited range of motion in the right hip, particularly internal rotation and flexion. Tenderness to palpation over the greater trochanter. No neurological deficits. Clinical Question: Rule out osteoarthritis or other bony abnormalities of the right hip. Please provide an X-ray of the right hip.

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