For GPs and physiotherapists

Referring a patient

How a referral pathway is structured, and what a referral generally carries. This is a fictional practice, and nothing entered below is sent, stored or seen by anyone.

What a referral generally carries

The administrative content of a referral is broadly consistent across specialist services: the patient’s full name, date of birth and NHI; current contact details; the referring practice and a name to reply to; and a clear statement of what is being asked for.

Where imaging has been done, the report is generally more immediately useful than the images alone.

A real practice sets out its own requirements, its own preferred channel and its own turnaround. None of that is stated here, because this is a fictional practice and inventing it would describe a service that does not exist.

A blank folder and pen on a pale timber desk beside a computer monitor

What this page does not say

It does not say when to refer, what to look for, or how a referral is triaged. Those are clinical judgements about suitability, and on a real practice website they would be written with the practice and signed off by a qualified reviewer before publication.

It also does not claim anything about how this practice processes referrals — no turnaround, no priority, no promise of a reply. A demonstration site has no operational record to draw those from.

The form below

It demonstrates the structure of the referral pathway: who is referring, how to reach them, and a short reason. It is the workflow being shown, not the criteria.

Nothing entered is sent, stored or seen by anyone. The form makes no network request at all when submitted, which is asserted by the QA suite rather than promised in a sentence.

Patient referral

This form demonstrates how a referral would reach a practice on a real website.

This form is a demonstration. Nothing you type is sent, stored or seen by anyone, and no enquiry reaches a clinician. Please do not enter any health information.

Fields marked required are required.

The practice you are referring from.

Preferred callback time

A few words is enough — for example "hip assessment". Do not include patient details or any health information.

Demonstration only. Nothing is sent, stored or seen by anyone.