Frequently Asked Questions

How do I create a referral form?

To help you speed up this part of the process, use the physician referral form template from 123FormBuilder and customize it. Don’t worry; you don’t need any technical skills. Use our drag and drop tool to add or remove fields and include your practice’s branding elements. Connect it to your favorite apps and tools and have your patient’s data safely stored in your system.

What should a referral form contain?

It’s up to you what you include in the referral form, but here are our recommendations for what to cover.
– The patient’s contact and personal details
– The physician’s name and contact information
– The diagnosis and the patient’s clinical information
– Reason for referral
– Patient’s medical history, including medications, restrictions, allergies, etc.
– Insurance information (if applicable)
– Time and date of referral and a signature

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