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General Practitioner Template

Referral Letter

About this template

This referral letter template is designed for General Practitioners to efficiently refer patients to specialists for further evaluation and management. It includes sections for clinical details, past medical history, current medications, recent tests, and results. This template ensures that all relevant information is communicated clearly to the specialist, facilitating a smooth transition of care. Ideal for use in Heidi, this template helps streamline the referral process, ensuring that specialists receive comprehensive and organized patient information. Perfect for high-volume searches related to medical referral form templates and medical progress note examples.

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[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 persistent chest pain. Clinical Details: Presenting Complaint: Persistent chest pain Duration: Symptoms have been present for 3 months Relevant Findings: Significant weight loss, abnormal ECG findings Past Medical History: Hypertension, diabetes Current Medications: Lisinopril, Metformin Investigations: Recent Tests: Blood tests, ECG, Chest X-ray Results: Elevated troponin levels, abnormal ECG findings Reason for Referral: Due to worsening symptoms and the need 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 Healthy Life Clinic

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