Site Map	Write a Ward Referral

• Fill in relevant patient details including (stickers acceptable)
  • Patient's name
  • Hospital ID
  • Date of birth
• Patients location (ward and bed number)
• Consultant name and address to whom referral is being made
• Discription of clinical problem
  • Reason for referral
• Urgency
• Summary of presenting complaint and examination findings
• Relevant histories
• Relevant investigations (including negatives)
• Medication and drug sensitivities
• What the patient has been told and patients understanding of the problem
• Sign form indicating status
• Print name, bleep number & referring consultant name

	Any comments or feedback please contact me by email: Tom Williams