Documentation · Referrals
Consultation
Patient
Always include identifiers at the top so the receiving team can locate the patient quickly.
Header
- Full name: [patient’s name]
- Civil ID: [civil ID]
- MRN: [MRN]
- Ward: [ward]
- Bed number: [bed number]
Letter
Dear colleague,
I am referring to you the case of [patient’s name], a [age]-year-old [gender] [nationality], known to have [chronic conditions], who presented with [brief HPI] and was admitted as a case of [admission diagnosis].
Currently, the patient is experiencing [symptoms related to reason for consult].
On assessment:
GCS: [x]
Vitals: BP [ ], HR [ ], RR [ ], temp [ ], SpO₂ [ ]
Examination: [relevant clinical findings]
Labs: [key abnormal labs]
Imaging: [relevant radiology findings]
Medications: [notable ongoing treatment]
I kindly request your assessment regarding [reason for consultation]. If applicable, I would appreciate your input on the following points:
· [specific question or issue]
· [any additional concerns]
Thank you.
Dr. [your name]
Notes
Please ensure adherence to your hospital’s referral protocol. A phone call may be required prior to sending this written consultation.
Template written by Dr. Cherifa Beghoura.
Last clinically reviewed · June 2026 · Last updated · October 2026
Get the free on-call checklist: one page for the whole shift.