10+ Best Medical Referral Form Templates

The purpose of a medical referral letter or form is to refer a patient to a doctor or vice versa in accordance with the specialization of the doctor and/or the illness of the patient. It is important that, while writing medical referral form, you are precise with what you want and what specializations you seek from the doctor. Medical referral form templates are formal documents, so, it is important that you write them in an efficient manner.

5 Steps to Write a Medical Referral Form

Step 1: Stay Away From Design

It might be that you look for beauty in all documents that you create, however, for a medical referral form, stick to your practice’s emblem only. Having too much design will only cause confusion in understanding the document. A medical referral form is a serious matter, make sure that you stick to its purpose.

Step 2: Use Clear Fonts

Due to the fact that a medical referral form has to be easy to understand, it should have clean and clear fonts. Having bold and simple fonts will allow people to understand your requests better, making your referral form easy to process. Using cursive tones for your font may create confusion, hindering the processing of your medical referral form.

Step 3: Create Several Sections

When you are referring a patient to a doctor who has a different specialization, you have to make sure that the doctor knows about what the patient’s symptoms are and why you think that doctor is great for the said patient. Creating several sections allows you to tick off symptoms and probable causes, letting the referred doctor know what he is getting into and has a slight notion of what is going on with the patient.

Step 4: Make It Straightforward

Medical conditions are supposed to be seen and processed immediately. When writing a medical referral form, make sure that you don’t divert your attention away from what is important by going into unnecessary details. Stick to what is crucial and get straight to the point, making sure that the referred doctor instantly gets a gist of what the patient is going through.

Step 5: Don’t Forget Your Signature

Last but not least, after you’re done writing your medical referral form, do not forget to sign it. Signing the form assures that you have authorized it. If you don’t sign the form, it creates unnecessary complications, drawing out the process even further. Sign the form to make sure that the process isn’t excruciating for anyone.

10+ Medical Referral Form Templates

1. Medical Referral Request Form

medical referral request form
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Size: 308 KB

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Issued by Stanford Healthcare, this medical referral request form has every aspect of what is expected from it. There is a section provided for you to request urgency if the medical case requires quick processing. You are also asked to describe the case if the said case is urgent, making sure that the form is processed quickly.

2. Standard Medical Referral Form

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Size: 107 KB

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This medical referral form is made specifically for children and for cases involving medical rehabilitation. There are a total of three sections for rehabilitation kind, with two having options between Inpatient and Day patient. The medical form is quite elaborate, making sure that the child is at his best when he is done with the treatment.

3. 2-Column Medical Referral Form

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Size: 143 KB

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Made specifically for child care, this medical referral form aims to be detail oriented in the way that there is ample space for the current doctor to mention why the child is being referred to another doctor. The form template also has a section for the current doctor to state his own diagnosis of the child.

4. Clean Medical Center Referral Form

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Size: 52 KB

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The referral form here is not particularly aimed at a doctor but the medical center itself. The referral form has adequate sections for the current doctor or clinic to describe the patient’s condition. The form template also has space for the physician to mention his details, making sure the referral is legitimate.

5. Free Physician Referral Form

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Size: 142 KB

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Issued by the medical center of The Ohio State University, the colors of this medical referral form match the colors of the university. The medical referral form has adequacy of information. There is also a section for the current doctor to state that ID proof of the patient is required.

6. Generic Doctor Referral Form

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Size: 69 KB

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This medical referral form template is the base of how referral forms are written and designed. The form is a great example of how to start a medical referral form. There is a huge section for the current physician to write down his comments regarding the diagnosis or the condition of the patient he is referring.

7. Modern Medical Care Referral Form

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Size: 104 KB

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Issued by the U.S. Department of Health and Human Services, this medical referral form has a lot of subsections for the doctor to fill in. The subsections allow for the current doctor to simplify the condition of the patient, so that the doctor who gets the referral will be knowing what is going on with the patient.

8. Printable Medical Referral Form

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Size: 42 KB

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The medical referral form here is issued by the Women, Infants and Children program, specifically the New York chapter. This referral form is for a physician to refer women, infants and children, who don’t have access to proper nutrition, to the program. This form, if approved, allows the above three categories of federal grants for food.

9. Professional Patient Referral Form

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Size: 40 KB

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Here, in this medical referral form, a dentist can refer a patient to a physician, incase the dentist does not have medical jurisdiction or knowledge towards certain health arenas. According to the form, the dentist can refer a patient to a physician when it comes to illnesses such as diabetes and chemotherapy.

10. Sample Medical Referral Form

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Size: 48 KB

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This medical referral form is short and straightforward. All that is to be known for reference is included in this form. There is an area for the current doctor to fill in the mobility status of the patient. Also included is an area where the current doctor can state the medical examinations the patient has been through.

11. Simple Medical Genetics Referral Form

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Size: 151 KB

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The medical referral form here deals mainly with genetic issues. In fact, the whole form is for the current doctor to refer the patient towards genetic examination. There are three reasons for referral mentioned in the form; general genetics, metabolic genetics and urgent cases and requirements.

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