Referral Letter Template

A formal specialist referral format with reason for referral, clinical context, and requested action.

Use this template in Notat, free

Blank template

Section headings in the order clinicians use them. Paste into your EHR or note tool.

1
Address
2
Reason for Referral
3
Clinical Context
4
Investigations to Date
5
Requested Action
6
Sign-off

Filled example

Patient

Referral letter: 36-year-old female referred for persistent iron-deficiency anemia

Address

Dear Gastroenterology Colleague,

Reason for Referral

I would appreciate your assessment of persistent iron-deficiency anemia despite three months of oral iron therapy.

Clinical Context

Ms. R. reports fatigue but no weight loss, abdominal pain, change in bowel habit, or visible gastrointestinal bleeding. Menstrual bleeding is moderate and unchanged. She has no family history of colorectal cancer. Examination today was unremarkable, including a soft, non-tender abdomen.

Investigations to Date

Hemoglobin 98 g/L, MCV 76 fL, ferritin 7 µg/L, and transferrin saturation 9%. Coeliac serology is negative. Repeat hemoglobin after three months of ferrous fumarate increased from 91 to 98 g/L. Renal and liver function are normal.

Requested Action

Please assess for an occult gastrointestinal source and advise on further investigation and iron replacement. I have attached the recent blood results and medication list. Please contact me if additional information is required.

Sign-off

Thank you for seeing her.

Yours sincerely,

Dr. Elena Rossi

General Practice

Example output — generated by Notat AI from a recorded consultation. This is a demonstration; actual notes vary by patient and encounter.

How Notat fills this in

You talk with the patient

Notat listens in the background. No dictation commands, no typing during the visit.

Facts come first

The FactsContext™ engine extracts the clinical facts, each linked to what was said, so you can check them.

The note is written from those facts

Notat fills in this template from the checked facts. You review, edit, and sign.

What this format captures

This example shows the structure clinicians use to keep the important parts of a consultation clear, complete, and easy to review.

From conversation to completed note

Talk naturally with the patient. Notat identifies the clinical facts, organizes them into the right sections, and writes the note in the format your workflow requires.

Let Notat write detailed notes from your consultations.

Notat extracts the clinical facts first, then writes the note from those facts for you to review and sign.

Use this template in Notat, free