About this resource
Vague referrals waste time. This template asks the referring clinician to state the question they want answered, the person's goals and consent, relevant background and urgency, and includes a response section so the loop is closed.
Purpose
To make internal referrals clear, purposeful and person-led, with a closed loop when the referral is answered.
Who it is for
Primary profession: Allied health and multidisciplinary teams. Also relevant for occupational therapists, speech pathologists.
Client or participant group: Allied health and multidisciplinary teams.
Practice setting: Community health, rehabilitation, disability and private multidisciplinary practice.
Suggested uses
- Referrals within a multidisciplinary team
- Referrals between services in a network
- Auditing referral quality
- Training new staff
Instructions for practitioners
- State the specific question you want answered.
- Confirm the person's consent and goals.
- Include only relevant background.
- Agree urgency and contact preferences.
- Complete the response section when the referral is answered.
Accessibility considerations
Note the person's communication and access needs so the receiving clinician can prepare.
Scope and limitations
A referral template. It does not replace your service's referral, consent and documentation requirements.
Research basis
Case management practice standards describe assessment, planning, coordination, review and planned exits with the person at the centre. Interprofessional collaboration interventions may improve professional practice and outcomes, although the evidence is still limited.
- Case Management Society of Australia and New Zealand. (2013). National standards of practice for case management (3rd ed.). https://www.cmsa.org.au/
- Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, Article CD000072. https://doi.org/10.1002/14651858.cd000072.pub3
What is included
A 3-page printable A4 PDF, including a practitioner notes page with the research basis (version 1.0).
Originality
Original Practitioner Plus content: wording, activity structure, layout and icons were created for this resource. No third-party worksheets, illustrations or text were reproduced.
