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Write a referral letter the receiver can triage

Put the question first and give the receiver what they need to answer it. Download the text file and paste it into your letter template.

Download the templateDownload it free with no sign-up and paste the plain text into any clinic system.

Fill in each section

SectionWhat to enterExample
HeaderWho the letter is to and from, the date and the patient's details.To: Cardiology clinic. From: Dr. Alex Sample, Anytown Health Center.
QuestionThe specific question you want answered, in one or two lines.Please assess for chronic coronary syndrome and advise on further investigation.
UrgencyThe urgency your local pathway defines, and the reason in one line.Routine. Symptoms stable for six weeks, no pain at rest.
HistoryThe presenting complaint with its timeline and the relevant past history.Six weeks of exertional central chest tightness relieved by rest.
Medications and allergiesCurrent medicines with doses and any allergies with the reaction.Ramipril 5 mg and levothyroxine 75 micrograms once daily. No known drug allergies.
ResultsResults that bear on the question, with values, units and dates.hs-troponin T 6 ng/L and LDL 159 mg/dL on October 14, 2026.
What I have doneInvestigations arranged and treatments started or stopped.Resting ECG done. CT coronary angiogram and echocardiogram requested. Lipid results discussed.
Patient and safety netWhat the patient knows, any communication needs and the safety-netting advice.Aware the referral is to look for heart disease. Advised to seek urgent help if pain at rest.

Copy the template

REFERRAL LETTER

HEADER
To:
From:
Date:
Patient name, date of birth and record number:

QUESTION
Question:

URGENCY
Urgency:
Reason:

HISTORY
History of presenting complaint:
Relevant past history:
Risk factors:

MEDICATIONS AND ALLERGIES
Medications and doses:
Allergies and reactions:

RESULTS
Result, value, unit and date:

WHAT I HAVE DONE
Investigations arranged:
Treatment started or stopped:
What I would like you to take on:

PATIENT AND SAFETY NET
What the patient knows:
Communication needs:
Safety-netting advice given:

Use it in four steps

  1. 1

    Write the question first

    Decide what you want answered before you write anything else.

  2. 2

    Quote results with dates

    Give values and units, and attach full reports rather than paraphrasing them.

  3. 3

    Say what you have done

    List pending and completed tests so nothing is repeated or missed.

  4. 4

    Record the safety net

    Tell the receiver what the patient was told to do while they wait.

Frequently asked questions

How long should the letter be?

Usually one page. Attach full reports instead of copying them in.

My service uses a referral form. Does this still help?

Yes. Use the form, and use these headings to fill its free-text fields.