GP referral letters

To facilitate effective triage, it is helpful if GPs include the following information in referral letters:

  • Specialty/sub-specialty that patient is being referred to
  • Referrer details
  • GP name
  • Practice name
  • Address
  • Telephone number
  • Date of referral
  • Patient details
  • Name
  • Sex
  • Date of birth
  • NHS/RXK number
  • Address
  • Telephone number (daytime or mobile if possible)
  • Medical history
  • Current medication
  • Significant history, including previous consultations for the same condition, name of consultant seen previously
  • Active problems
  • Clinical information
  • Referral priority (urgent/routine)
  • Reason for referral
  • Preliminary investigations and results, as well as management appropriate to reason for referral
  • Information regarding special/social circumstances (Does patient have hearing, visual, mental health difficulties or mobility impairment? Is an interpreter needed?)

For further information on services provided, queries, comments or suggestions, or specialties and services published on the directory of services, please contact the CAB Team on telephone: 0121 507 6442 or email: kuljitkaur@nhs.net.

Suspected Cancer Referral

Please use the forms below for suspected cancer referrals in order to achieve the 2WW rule:

Breast form
Colorectal Form
Gynae Form
Haematology Form
Head & Neck Form
Lung Form
Skin Form
Upper GI Form
Urology Form

Hip, Knee and Shoulder Referral Forms

Hip knee shoulder Referral LV
Hip knee shoulder Referral TPP
Hip knee shoulder Referral INPS
Hip knee shoulder Referral PCS

CRS Service Referral

CRS Service Referral

Physio Refferal

Physio Referral Form