Do you run a hospital or clinic? From time to time, other doctors and hospitals will refer a patient to yours. When this happens, you’ll need some background information on the patient. Medical referral forms help to collect much of the information you’ll need. If you’d like to get started with a template, this WPForms’ Medical Referral Form Template would be perfect!
When patients are referred between medical facilities, it’s really important to ensure that all the relevant data is properly communicated from the referring doctor to the receiving one. This is important to help the receiving doctors make informed diagnoses.
The WPForms’ Medical Referral Form Template does this really well by using a mix of form fields. First, the template offers a single-line text field to capture the referring hospital’s name. This is accompanied by the Email, Phone, and Address fields.
The next section is nearly identical, as it uses similar fields to collect the referring doctor’s contact information. The rest of the template is dominated by paragraph text fields where referring doctors can provide notes on things like medical history, family medical history, their comments, and so on.
Other than these, the Medical Referral Form Template has a date field and a signature field for the referring doctor to sign.
Get started with WPForms today to create and customize your own medical referral form. Signing up with WPForms gives you access to this and hundreds of other pre-made templates.
