Referral Forms

To refer a patient simply complete one of our referral forms and post, email or fax the form to us, or alternatively use Choose & Book

Our referral forms are available in various versions that are compatible with your GP surgery I.T system. Your practice and referrer details will populate automatically, together with patient contact detail, demographics and patient history.

Please note that our email address for referrals is   

Select which referral form version you would like from the options below:  If you would like help in integrating a referral form with your GP system please see the help documents below. (In the Word section for EMIS WEB or PDF section for help with Vision and EMIS PCS).   Please note that InHealth were sent these help documents from a friendly CCG source - we have no access to GP systems and so do not know if the information in them is accurate.  If you are unsure, please speak to whomever deals with IT in your practice.

We have been contacted by some practice managers who have struggled with the EMIS WEB referral forms loaded here.   We have been told that the EMIS LV version (also available here) will  work with EMIS WEB .   Please do let us know if you have a different experience!

To refer a patient, simply complete one of our referral forms and send it to us or book the patient appointment using Choose & Book.



0333 202 0297
Fax: 0333 200 1163
0333 202 0300
Referring Clinicians / Reporters
0333 202 0297
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