General Practice

Referral Letter Template

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

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

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.

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