Medical Referral Letter Samples

Subject: Referral for High-Risk Pregnant Patient

Dear Dr. [doctor name], I hope this letter finds you well. I am writing to request a referral for my patient [patient name], who is [mention number of weeks of pregnancy] weeks pregnant. She is a 40-year-old with one previous normal delivery without any complications. However, this time, it has come to my attention that her pregnancy is presenting some complications for which [mention hospital name] does not have the necessary equipment or capabilities.

[Patient name] is presenting symptoms of [briefly mention complications or condition], which makes her pregnancy high-risk. Her current condition leads us to believe she requires constant monitoring, specialized care, and medical experts, which we at [hospital name] currently lack.

After assessing all the options, we have come to believe it would be best for [patient name] to be referred to your care in [hospital name]. We have full confidence in your expertise and see that [hospital name] would not only be the most convenient to [patient name], but it also has all the necessary resources and monitoring that she requires.

I would request that you please accommodate [patient name] as a patient in your hospital and provide her with the necessary monitoring and care that she requires for the rest of her pregnancy until delivery. Without the necessary monitoring and care, I fear she would not be able to achieve the outcome we wish for her and her baby.

For your viewing, I have attached [patient name] medical records, history, relevant documentation, and the latest copy of an ultrasound.

Please do not hesitate to contact me directly at [phone number] or email me at [email address] if you need to further discuss this case. My team and I are committed to providing any help that may be needed to facilitate a smooth transition for the well-being of [patient name].

I will be grateful for your expertise and support in helping us manage this high-risk pregnancy. My team has informed [patient name] and her family of the referral, and they are eagerly looking forward to receiving the best care at [hospital name].

Kindly treat this case as urgent.

Thank you,

[Doctors name]

[Doctors credentials]

Medical referral letter template



Subject: Referral of Patient

Dear [doctor name],

I hope this letter finds you in good health. I have a patient [mention name], who I would request to refer to your care for a complete neurological evaluation and care.

I have been treating [patient name] since [mention date] due to [mention medical condition]. At this point in her treatment, I would require his/her comprehensive neurological evaluation. This is because, despite all the tests, monitoring, and treatments, his/her condition has not shown the desired improvement. This is why I have come to believe that his/her case now requires an examination by a neurologist.

After I looked into [patient name]’s most recent diagnostic result, it became clear that he/she requires a specialized neurological assessment to rule out any issues with the brain that may have gone unnoticed. I have trust in your knowledge in the field of neurology and would rely on your judgment for the neurological evaluation of [patient] and, if needed, the best care as well.

I understand you have a very tight schedule, but I would request that you please schedule an appointment with [patient name] at your earliest convenience and initiate a detailed neurological evaluation. Kindly keep me in the loop regarding all assessments and any possible treatment plans, if need be. Currently, I haven’t prescribed any medications to [patient name], as I shall do so after your evaluation.

If you have any questions or would like to have a detailed discussion, please do not hesitate to call me at [mention number] or email me at [mention email address].

I am confident that your years of experience and specialized care unit will definitely benefit [patient’s name] in ruling out any of his/her neurological issues, if any.

Thank you for your attention to this referral, and I look forward to collaborating with you in the best interest of our patient’s health.


[Dr. Name]

[Dr. Credentials]

[Dr. clinic/hospital name]

Medical referral letter template

You may also like...