Doctor Referral Forms

If you are sick or need some medical advice, you have to visit a doctor for treatment. The organizations usually offer health insurance to their employees, and these insurance agencies are connected to a group of healthcare providers. You are then referred to the type of consultant you require for your treatment.

It could be possible that you visited a general physician, and he referred you to a specialist for specific care. Whatever the route, if you are referred to a physician, you have to fill out a doctor referral form to complete the documentation formalities.

What is a doctor referral form?

A doctor referral form is a form that your physician needs to fill out and sign before referring you to a specialist for further treatment and diagnosis. The referral form holds complete patient information, the results of the tests performed on the patient, the reason for referring, etc.

What should I add to the form?

This is a straightforward form where you fill in the blanks with your name, contact information, age, gender, and date of birth. A section of the form asks you about your insurance provider’s information. All these requirements are necessary to keep a record of your health or disease (if any), and you can claim insurance on such referrals easily. Every health center has designed their referral forms according to their specifications, but the general format is the same. The form is signed by the patient and the doctors as documented proof.

Getting a correct diagnosis can be a very lengthy process, yet it is very important for your health and life. If you do not know which doctor to consult, ask your general physician to refer you to one. He might need different tests done before he can determine which doctor to refer him to. Different diseases and conditions can have overlapping and similar symptoms. Even the medical tests you get done cannot be differentiated by your general physician or medical specialist. That is where a specialist doctor comes in.

Key information added to the form

A doctor referral form holds the following information:

  • The name and age of the patient
  • Contact information of the patient
  • Symptoms and signs in detail
  • Names of the test performed and their results
  • Treatment Given to the patient
  • Brief medical history of the patient
  • Reason for referral
  • Name and specialty of the doctor referred to
  • Signature of the referring doctor

Your general physician or medical specialist might refer you to a doctor in the same clinic or hospital, or he might refer you to a specialist outside of the medical facility. In the case of a referral to an outside or visiting doctor, additional information about his clinic or hospital is also mentioned in the doctor referral form.


Doctor referral form template

See also: Doctor referral forms for various purposes

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