Doctor Referral Form

Easily refer your patients to specialists by pairing this doctor referral form template with Formstack's HIPAA compliant solution.

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Sharing information between doctors is anything but easy, especially if paper forms are still involved. It can be frustrating when EHRs can't share the data electronically. Minimize your time spent filling out paper forms and maximize the time you have with your patients by implementing this doctor referral form. This template makes it easy to send a thorough outline of your patient interactions to specialists inside or outside your network.

Stay secure.

Stay secure.

We know that the security of patient health data is incredibly important to you and your patients. With Formstack's HIPAA compliant solution, you can collect and share PHI across any device while maintaining the security of patient data. Formstack encrypts information and safely stores it in a database, keeping your organization compliant with HIPAA regulations. Take advantage of our HIPAA compliant integrations to simplify other aspects of your healthcare data collection.

Customize to your needs.

Customize to your needs.

Use the Conditional Logic tool to customize this referral form to meet the needs of different patients. For example, when referring a patient to a cancer specialist, you can set your doctor referral form to dynamically ask for the patient's family history of cancer. If you refer to multiple doctors within specialties, you can include each doctor as an option and prefill the form with their information to avoid spending excess time on manual data entry.

Make sharing easy.

Make sharing easy.

Navigating email and fax is tedious and can cut into the time you spend with patients. Stop sifting through paper files and email threads by adding a File Upload field to your form. Formstack accepts multiple file types, including documents, pictures, and videos. Easily attach lab results or images to this template and share them with other practitioners.

Produce better results.

Produce better results.

Specialists often receive no health history before meeting with referred patients. Paper files are often misplaced or faxes fail to send, and patients are forced to rehash their lengthy health histories. Improve your referral process by adding a digital workflow to your form. Creating a streamlined workflow will help you simplify data management, improve communication, and dedicate more time to your patients.

Social Proof

"Formstack increases the speed and efficiency and cuts down on the duplication of data entry for both patients and staff members."

Dr. Chris Bojrab,
President of Indiana Health Group

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