Medical Referral Letter Template with Examples

Shine Colcol

February 20, 2025•16 min read

Fact checked by Dr. Ben Condon

Template

Medical Referral Letter Template

This medical referral letter template, also known as a patient referral form template, covers key components such as patient and clinical information, reason for referral and request for action, and contact information and supporting documentation. With Heidi, you can use AI to automatically generate referral letters that:

Includes key details such as the patient’s name, date of birth, medical history, current medications, and presenting symptoms. Summarizes recent findings such as test results to ensure the receiving specialist is given sufficient context for the referral.
Clearly states the intent of the referral and specific areas of concern (e.g., persistent chest pain, abnormal ECG findings). Requests the specialist’s evaluation and management recommendations to further inform the continuation of treatment.
Includes contact information from both the patient and referring doctor for the receiving specialist’s reference. It also mentions any inclusion of test results and other reports to ensure that the receiving specialist has all necessary supporting documents.
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What is a Medical Referral Letter Template?

A medical referral letter template is a standardized format used by doctors to refer their patients to a specialist if necessary for their treatment. It usually includes the patient’s personal information (e.g., name, age, address etc.), their medical history, the reason for the referral, and the referring doctor’s information.

In this article, we’ll cover the importance of a medical referral form, the different types of doctor referral letter templates used by healthcare providers, and tips on how you can write your own patient referral form. Additionally, we’ll provide you with ready-made medical referral form templates which you can customize or use directly for your daily practice.

Why a Medical Referral Letter Template is Essential

A medical referral letter template, sometimes known as a doctor to doctor referral letter

template, is vital for ensuring that referrals are consistently clear and comprehensive. Effective communication between healthcare professionals is crucial for accurate diagnosis, and a successful treatment plan.

Ensures Clear and Consistent Communication

A standardized template gives medical professionals a structured format when presenting patient information. The consistency provided by a template reduces the risk of missing important details, helping specialists quickly understand the patient’s condition. This leads to more accurate assessments and timely care.

Boosts Efficiency and Saves Time

‍A template streamlines the referral process since healthcare providers can quickly fill in the necessary details without starting from scratch. They also help doctors maintain thorough documentation standards even while managing a higher volume of referrals.‍

Supports Treatment and Collaboration

A doctor referral template facilitates seamless collaboration between the referring provider and the receiving specialist. It ensures that all pertinent patient information is shared completely and accurately; empowering the specialist to make data-backed decisions for the well-being of the patient.

Note that a “code of conduct” typically outlines the principles for making proper and valid referrals between healthcare providers. These standards may vary based on local laws and regulations.

Referral guidelines for healthcare providers vary across countries, with each governing medical body establishing standards to ensure patient safety and effective care coordination.

In the United States, the American Medical Association (AMA) advises that physicians base referral decisions on patients' medical needs, ensuring that consultants have the appropriate qualifications and skills. Physicians are also encouraged to respect patients' rights to seek second opinions and to provide clear explanations for any recommended consultations.
In Canada, the Canadian Medical Association (CMA) emphasizes that physicians should accept new referrals on a first-come, first-served basis, free from discrimination, and triage patients based on the urgency of their clinical needs.
In the United Kingdom, the General Medical Council (GMC) emphasizes that when delegating care, doctors must be confident that the healthcare professional they refer to possesses the necessary knowledge, skills, and training to perform the required tasks safely.
In Australia, the Medical Board of Australia's code of conduct outlines principles for good referrals between medical professionals, including verifying the specialist's qualifications, maintaining responsibility for the patient's overall care, and providing sufficient information for accurate assessment and treatment.

Types of Referral Letters in Healthcare

There are different variations of medical referral letter templates. Different types are used depending on the level of urgency, or the nature of care and assistance required. Below are some of the most common patient referral forms used in healthcare today:

Specialist Referral Letter

Used by general practitioners or GPs to refer patients to specialists when their treatment necessitates a more thorough investigation and diagnosis e.g., cardiologist, dermatologist, etc. The specialist often writes a letter back to the referring physician to share important information about the referred patient’s condition, treatment, and next steps.

Surgical Referral Letter

Used to refer patients to a surgeon or surgical department if their treatment requires an assessment for a potential surgical procedure. Typically mentioned here are the patient’s medical history, test results from previous assessments, and the reason for considering surgery.

Mental Health Referral Letter

Used to refer patients to psychologists, psychiatrists, or counselors for mental health assessments and potential treatment. Typically outlined here are symptoms, the patient’s mental health history, and previous treatments.

Diagnostic Referral Letter

Used to refer patients for specific diagnostic tests e.g., X-ray, MRI, CT scans, and other necessary laboratory assessments. These letters usually outline the observed symptoms and the clinical question to help guide the diagnostic procedure.

Rehabilitation Referral Letter

Sent to physiotherapists or rehabilitation specialists for patients requiring therapy to recover from injuries, surgeries, or chronic conditions. Typically outlines observed symptoms, the patient’s medical history, and any other previous treatments.

How to Write a Medical Referral Letter with Examples

A clear and effective medical referral letter is essential for streamlining communications between healthcare providers. A good medical referral form should be concise, informative, and easy to comprehend.

Clinicians also have varying preferences around the use of narrative, which although more traditional and formal can be harder to digest. We suggest a mix of formalities and bullet points where you can improve readability and focus. In Heidi, we achieve this effect with the use of different voices in our generated outputs from Brief to Super Detailed.

Below is a simple guide to crafting a professional medical referral letter:

1. Header with Practice Details and Date

Open with your practice letterhead which includes your clinic’s name, and contact information, along with the date of the referral.

Example:

Healthy Life Clinic
123 Wellness Street
18 December, 2024

2. Recipient’s Information and Greeting

Afterward, include the specialist’s full name, department, hospital name, and address.

Example:

To:

Dr. Sarah Johnson
Cardiology Department, St. Mary's Hospital
123 Heart Lane
Newtown, NT 45678

3. Patient Identification and Reason for Referral

Clearly state the patient’s name, date of birth, and the reason for the referral.

Example:

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 persistent chest pain.

4. Clinical Details

List the patient’s symptoms, relevant medical history, and current medications to provide context for the referral.

Example in points:

‍Presenting Complaint: Persistent chest pain
Duration: Started 3 months ago, constant and episodic since.
Relevant Findings: Significant weight loss, abnormal ECG findings
Past Medical History: Hypertension, diabetes
Current Medications: Lisinopril, Metformin

Example in paragraphs:

‍For the past three months, the patient has been experiencing persistent chest pain, described as both constant and episodic in nature. Alongside this, there has been significant, unexplained weight loss.

A recent ECG revealed abnormal findings, raising further concerns. The patient’s medical history includes hypertension and diabetes, for which they are currently taking Lisinopril and Metformin. Given the duration and associated symptoms, further investigation is warranted to determine the underlying cause.

5. Investigations and Test Results

Provide a summary of recent investigations and their outcomes to help the specialist assess the patient’s condition.

ECG revealed an early P-wave rise with a shortened PR interval, raising suspicion of an underlying atrial conduction abnormality. This, coupled with subtle ST-segment deviations and borderline QT prolongation, suggests a possible early-phase channelopathy. Notably, blood tests indicated elevated troponin levels, hinting at myocardial stress or subclinical ischemic activity. While the chest X-ray was unremarkable, these findings necessitate a deeper electrophysiological assessment.

6. Reason for Referral and Request for Action

Clearly explain why you are referring the patient and specify what input or evaluation you are seeking from the specialist.

Example:

‍A targeted workup, including echocardiography, Holter monitoring, and genetic testing for inherited arrhythmic syndromes such as Brugada or progressive conduction disease, is the suggested course of action, out of scope for my practice and they will be well placed in your capable hands.

7. Patient Contact Information and Enclosures

Include the patient’s contact details and mention any supporting documents you are sending with the letter.

Example:

‍Patient’s Contact Information:Phone Number: 555-123-4567
Email Address: johndoe@gmail.com

8. Referring Doctor’s Contact Information and Closing Remarks

End the letter with your full name, title, practice information, and contact details for follow-up.

Example:

‍Thank you for your attention to this referral. I look forward to your evaluation and recommendations.Yours sincerely,

Dr. Thomas Kelly
General Practitioner
Healthy Life Clinic
Phone: 555-987-6543
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Medical Referral Letter Template Example

Easily Prepare Medical Referral Letters with Heidi Health

While manually writing medical referral letters provides a personal touch, all manual processes by nature are time-consuming and susceptible to errors. With the latest advancements in technology, Heidi Health’s AI medical scribe can offer a faster, more efficient alternative for medical practitioners.

General Practitioner, Dr. Gihan de Mel, uses Heidi to create fast and accurate medical referral letters. “The good thing about Heidi is that you can write a prompt and say, ‘Can you please write a referral to the physiotherapist about this patient?’ and it will rephrase the entire conversation with the patient and formulate a referral for you.”

Here’s how Heidi helps your medical practice in three simple steps.

Transcribe - Your patient explains their symptoms, medical history, and other concerns over a microphone and Heidi captures every essential detail, word-for-word.
Customize - Afterwards, simply pick your preferred medical referral letter template and watch as Heidi perfectly rephrases and transcribes your patient’s information into the appropriate format. You can also input information from your own findings and observations, and Heidi will take care of the rest!
Transform - Additionally, you can ask Heidi to create anything else you need; may it be patient summaries or other documents.

Heidi is compliant with international data privacy and security standards, including HIPAA, ISO 27001, and SOC 2 certifications. We adhere to jurisdiction-specific regulations, ensuring data localization for customers in Australia, Canada, the United States, and the United Kingdom. Read more about our compliance here.

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Free Medical Referral Letter Templates

Medical Referral Form

This medical referral from template helps clinicians provide clear, structured summaries of patient consultations, including medical history, findings, and treatment plans.

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Doctor Referral Letter Template

This doctor referral letter template helps general practitioners efficiently share patient information with specialists, covering medical history, medications, and presenting complaints.‍

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Patient Referral Form Template

This patient referral form template helps clinicians communicate patient information, medical history, and referral reasons clearly to dental specialists.

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FAQs About Medical Referral Letter Templates

How do medical referral letters work?

Medical referral letters are formal documents that healthcare providers use to transfer a patient’s care to a specialist, summarizing the patient’s medical history, current condition, and reason for referral.

How do general practitioners write medical referrals to different specialists?

General practitioners write medical referrals by summarizing the patient’s medical history, current symptoms, and test results, then clearly stating the reason for referral and the type of specialist needed.

How can I create a medical referral letter template for my practice?

To create a medical referral letter template for your practice, include sections for patient information, medical history, presenting complaints, test results, and the reason for referral. With Heidi, the AI medical scribe for all clinicians, you can streamline this process by automatically rephrasing and transcribing patient information and the doctor’s input into the chosen medical referral letter template.

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