Emergency Medicine Template

Referral Letter from ED/ ER

A professional Emergency Medicine template for healthcare professionals.

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  • OVERALL_INSTRUCTIONS

    Omit any sections that do not have information

  • Chief Complaint

    [Provide detailed description of patient's presenting symptoms including onset, location, character, radiation, associated symptoms, and timing]

  • Template

    Dear Dr. [Specialist's Last Name], [Specialist's Title], Thank you for seeing [Patient First Name] [Patient Last Name] for further evaluation and management. [He/She/They] presented to the ER on [Date of Appointment (YYYY-MM-DD)] with [Chief Complaint]. [Provide detailed description of patient's presenting symptoms including onset, location, character, radiation, associated symptoms, and timing]. [Patient Last Name]'s relevant medical history includes: - [List relevant past medical conditions] Existing Medications: - [List all relevant medications with dosages] Examination Findings: - [Provide detailed vital signs and physical examination findings] Assessment: [Provide concise clinical assessment or provisional diagnosis] Investigations and management done in the ER included - - [List all investigations performed and their results] - [Describe treatments administered including dosages and routes] Your expertise would be greatly appreciated in assisting with further management strategies for this patient. Thank you for your attention to this matter. Yours sincerely, Dr. [physician name]

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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.

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