ENT or Medical Specialist Referral Letter

Referral Letter Referring Clinician: [Insert referring audiologist’s full name, professional designation (e.g. community service audiologist, senior audiologist), affiliated clinic or hospital, and available contact details such as phone or email] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in full sentences as a paragraph.) Patient Details: [Insert patient’s full name, date of birth, folder number or hospital/clinic reference number, and contact number if available. Include caregiver/parent name if applicable for paediatric patients.] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in full sentences as a paragraph.) Reason for Referral: [State the main reason for referral, including key audiological findings, red flags (e.g. asymmetry, sudden loss, otalgia), or persisting symptoms that require medical or specialist evaluation] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in full sentences as a paragraph.) Relevant Audiological Findings: [Summarise audiological test results relevant to the referral decision. Include available findings such as:] - [Pure tone audiometry results] - [Tympanometry classification and reflexes] - [Otoacoustic emissions (OAE) outcomes] - [Speech discrimination or speech reception thresholds] - [Screening outcomes (e.g. school-based hearing screen fail)] (Only include if explicitly mentioned in transcript or context, else omit section entirely. List items as bullet points.) Clinical History and Background: [Provide brief history including onset and duration of hearing loss or symptoms, presence of otorrhoea, history of recurrent ear infections, known exposure to ototoxic medications, TB, HIV, noise exposure, and family history of hearing loss if applicable] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in full sentences as a paragraph.) Previous Interventions or Management: [Detail any previous or current management strategies such as:] - [Hearing aid fitting or trial] - [Medical or antibiotic treatment for infections] - [ENT or paediatric referral already made] - [Audiology follow-up reviews or school-based support] (Only include if explicitly mentioned in transcript or context, else omit section entirely. List items as bullet points.) Referral Objectives or Questions: [Clearly state the reason for referral – e.g. to rule out middle ear pathology, evaluate for surgical intervention (e.g. grommets), assess for sudden sensorineural hearing loss, or provide medical clearance for amplification. Include any specific questions the audiologist would like addressed.] (Only include if explicitly mentioned in transcript or context, else omit section entirely. Write in full sentences as a paragraph.) (Use as many lines, paragraphs or bullet points, depending on the format, as needed to capture all the relevant information from the transcript. 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 included 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 that the information has not been explicitly mentioned in your output. Just leave the relevant placeholder or section blank if not explicitly mentioned.)