Physician Referral Form

Get access to an intuitive and easily downloadable physician referral form template. Designed to simplify the referral process and improve patient-provider communication.

By Chloe Smith on Mar 06, 2024.

Fact Checked by RJ Gumban.

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What is a Physician Referral Form?

A physician referral form is a key document used in almost every single healthcare practice, regardless of specific specializations. These documents are a necessary component of referring a patient to another facility or physician. They help to inform the coordination of care and ensure that communication remains transparent between all physicians involved in a patient’s care. Referral forms are often used by general practitioners who are referring their patients to a specialist for a diagnosis or further treatment. These forms are especially important when it comes to the patient being covered by an insurance provider. For appointments at a specialist’s clinic to be covered by insurance, it is often the case that a referral from a general practitioner or primary physician needs to have been written.

To assist you in the process of referrals, we have created an intuitive template. It can be downloaded and accessed for free, giving you instant access (either electronically or physically) whenever you may need it. In this guide, we’ll outline the steps involved in using this template before highlighting some of the specific benefits associated with the document. Let’s get started!

Printable Physician Referral Form

Download these templates for a physician referral form to improve your therapy intake process and HIPAA compliance.

How to Use This Template for Physician Referral Form

The whole purpose of utilizing new forms and resources is to simplify processes at your healthcare practice. To ensure this is a reality, we’ve curated an easy-to-follow step-by-step guide that details how you can maximize your use of our physician referral form template

Step One: Download the template

Evidently, the first thing you need to do is download the PDF template. There is a link included on this page that should open in a PDF reader on your device. From here, you can download the template onto your computer, where it can be accessed at a later date. You can choose to either store electronic copies, or if it is your preference, you can print the form and use physical copies. 

Step Two: Complete the form

When you are in the process of referring a patient to a specialist, you need to complete the form. Because this step usually happens during an appointment with a patient, it’s a good idea to have the document stored somewhere it can be quickly and easily accessed. This ensures a seamless referral process that doesn’t interrupt your or your patient’s time. 

Step Three: The patient takes the form to the specialist

After the referral form has been completed and given to the patient, they need to take it to their specialist. There are different regulations concerning how long a referral form is valid, so you should ensure that your patient is aware of these.

Physician Referral Form Example (Sample)

To help physicians better understand how the physician referral form works, we have created a sample template. This is based on an appointment between a general practitioner and a patient, where the GP has referred the patient to a specialist. Although the contents of our sample referral form will evidently differ from yours, this example should give you insight into how they will work

Download this Physician Referral Example (Sample) here: 

Physician Referral Form Example (Sample)

Who Can Use this Printable Physician Referral Form (PDF)?

We have attempted to keep our physician referral form fairly general, while also ensuring it is comprehensive enough to be effective. Given this, the template is applicable to a range of different practitioners, including:

  • General Practitioners
  • Physical Therapists
  • Massage Therapists
  • Nurses
  • Psychologists
  • Optometrists
  • Social Workers
  • Dentists

While most of these healthcare practitioners are able to refer patients to a wide range of specialists, there are certain treatments, interventions, tests, and scans that require specific providers to write the referral. For example, some types of MRI scans can only be referred to by certain specialists. If you don’t see your field of healthcare or specialization on this list, then don’t worry, it doesn’t mean you can’t use the template. Essentially, if you are a physician who refers patients to other physicians then our form will almost certainly work at your practice.

Why is This Form Useful for Physicians?

This physician referral form has a range of different uses for practitioners during their day-to-day schedules. These include:

  • Automate the referral process: Referrals are a fundamentally essential component of working in healthcare, yet staying on top of them can take time and effort. With this template, you can streamline the process of writing referrals while also ensuring your patients are receiving the best quality of care possible. 
  • Improve the organization of your documents: Everyone knows that healthcare practitioners are required to write many different kinds of documentation. Although these are critical for ensuring the healthcare process is transparent and patients are receiving good care, it can quickly become overwhelming. Using a physician referral template will help you to stay on your documentation and ensure it is highly organized. This will make things much easier for you, your patient, and the specialist they are being referred to. 
  • Saves time: Lastly, using the physician referral form will also help you save time. Managing administrative tasks can be a difficult and time-consuming aspect of working in healthcare, but using a form that can be accessed with a couple of clicks will save you a lot of time without compromising patient care.
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Why Use Carepatron For Physician Medical Referral Form?

Investing in practice management software is one of the best decisions you can make for your healthcare practice in today’s increasingly digital age. Carepatron, a leading solution, has been designed in collaboration with healthcare practitioners, ensuring its features will elevate your processes. In addition to having a robust set of templates, Carepatron has a range of other tools that can optimize the referral process. Integrated with a secure patient portal, clients can access their appointment and payment information, as well as be able to easily communicate with their primary physician. This tool enables patients to have a more involved role in managing their care, while also streamlining referrals.

In addition to offering patient engagement tools, Carepatron is integrated with a range of other practice management features, all designed to streamline administrative and clinical processes at your business. These include appointment scheduling, medical billing and coding, clinical documentation, and mobile health. With Carepatron at your practice, you will be guaranteed to save both money and time, allowing you to pursue your professional goals and focus on delivering high-quality care to patients in need.

Electronic health record software benefit
Why are physician referrals done?
Why are physician referrals done?

Commonly asked questions

Why are physician referrals done?

Referrals are completed in healthcare for a few reasons. They are critical for ensuring patients receive the kind of care that they require. Physicians will have extensive professional networks and so are the most capable of putting patients in touch with the necessary physicians. Referrals are also important for allowing patients to receive insurance coverage and establishing good communication between different healthcare facilities.

When do you need to complete a physician referral form?

Physician referral forms should be completed every time that you refer a patient to a specialist. It is a good habit to keep your forms accessible so they can be filled out at the end of a session with a patient. This will allow your patient greater flexibility when it comes to booking their first session with the specialist and also saves you from completing extra documentation in your spare time.

Do all insurance providers require a referral form?

Although insurance provider policies differ, the general answer is yes. Most insurance providers require a referral form in order for the patient to be covered. Before you write a referral or accept a patient’s insurance, you should validate the provider’s coverage and ensure that the patient is aware of the financial responsibilities.

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