Concise Referral Letter
A professional Family Medicine template for healthcare professionals.
Preview template
OVERALL_INSTRUCTIONS
keep it concise, provide key objective data, include only history relevant to the referral. If any sections have no information, omit the section
Chief Complaint
Further evaluation and management of abnormal lung function with obstruction and persistent shortness of breath with exertion
Template
I am referring a patient [Patient First Name]. [He/She/They] is a [Patient Age]-year old [male/female/other]. Reason for Referral : [list the reasons for referral, including any specific symptoms or conditions that require further evaluation and management.] History of Current Illness : [Provide a concise summary of history relevant to the referral, including symptoms, onset and duration, previous diagnoses, relevant comorbidities, and any functional impact. Mention any specific concerns or potential diagnoses that need confirmation. Do not include test results in this section] Investigations : [List any tests, investigations conduced, and management to date, and any other relevant intervention] Summary : [summarize specific request to the specialist or consultant, for example, I would appreciate your assessment and management in .....for opinion regarding...for surgical evaluation of ...] Thank you for seeing this patient.
Like what you see?
Import this template and make it yours. No need to build from scratch—just customize and you're ready to go!
How to use this template
This comprehensive new patient template helps establish care by capturing complete medical history, current concerns, and baseline health status. Use this for patients during their initial visit to create a thorough medical record.
Ready to use this template?
Start using this template in your practice for free or share yours with the community
Free to use • Customize for your practice • AI-powered redaction • Share templates in under 5 minutes