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Sample of Referral Letter from Doctor

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Sample of Referral Letter from Doctor

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  • November 3, 2012
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SIME DARBY MEDICAL CENTRE
Subang Jaya 1 Jalan SS 12/1a
47500 Subang Jaya, Selangor

March 17, 2012

Dr. Gan Kien Wei
BOAS Home
95G Jalan Perak
Kampung Bukit Kuda
41300 Klang

Dear Dr. Gan
TRANFER OF PATIENT TO BOAS CLINIC
Refer to the matter above, on the 25th of March, one of my patient named Ms Goh Li Wei will be transferred to BOAS home. As this patient had been treated by me for a long time, I would like to provide some information and backgrounds of her to you. With that, work would definitely become easier when she is at BOAS home.

Miss Goh is now 53 years old. She was admitted into Sime Darby Medical Centre last year on the 15th of December 2012 due to serious fracture of the ankle bone. The cause of this injury was that she fell from the stairs in a hypermarket. In the past 2 months, she had been treated by me and now becoming better where palpation on the injury area would cause pain anymore. However, she is still having difficulties in walking where there is weakness on the ankle joint caused by the injury. Since BOAS Home is having a well-known physiotherapist and Ms Goh has no family member to take care of her, therefore, she will be sent to BOAS Home to have treatment for few months.

Ms Goh has a normal mental state. One thing about her attitude is that she is a hot tempered person and she gets frustrated easily when she does not get what she wants or needs in time. For example, food is preferably sent to her on time. Besides, she has Parkinson’s disease. Every time after meal, medicine has to be given to her. She has no vision problem but a little hearing loss. So I would like to advice the physiotherapists in-charge to raise their voices when they are giving instructions to Ms Goh during treatment time. In addition, she has allergy to prawn. Therefore, it is better that her meal should not contain any prawn.

If you have any further questions, please call my office at (555) 555-4272.

Yours truly

Dr. Tan Kar Wai