Referral Letter from Doctor

Referral letter is usually written by doctors when they refer any patient to some doctor such as specialists in the particular field to cure special diseases. Referral letter is especially written for those patients, who need some specialist, and you as a doctor have particular relationship with specific doctor then you should write it in detailed manner. A doctor needs to write referral letter following a particular format. It is a kind of formal letter therefore while writing you should take care about requirements of formal letter. Here I will discuss some important points that should be included in referral letter regarding patient:

Here I am designing a sample referral letter from doctor for all doctor’s convenience so that they can easily draft at any time without any problem. This letter is designed by following specific format of sample referral letter from doctor.

Sample Referral Letter from Doctor

[Your Name]
[Street Address]
[City, State, Zip Code]
[Phone Number]
[Postal Code]
[Email Address]

[Date of Letter Writing]

[Name of Recipient]
[Address of Recipient]
[Name of Organization]
[City, State, Zip Code]
[Phone Number]

Dear Sir/Madam,

Thank you for referring [write patient name here] to [write center name here]. Our team has conducted a thorough clinical evaluation. Upon discussion of our doctor’s panel and patient’s goal [write here goal of patient] we decided to perform a [write test or therapy name here such as Intrathecal Baleen Therapy] screening test.

The [write name of test] involved [XX] mcg bolus of baleen injection via lumbar puncture. [You can also include information on physical therapist evaluation, such as times of evaluation and results of evaluation]. Based on the results of [write name of tests] we plan to precede with implementation of the [write name of drug] Drug Infusion System for delivery of [write name of therapy] at [write date here].

Thank you once again for your referral. If you have any question please contact me at [write your phone number here].

Your Sincerely,


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