Tool to assess the quality of consultation and referral request letters in family medicine

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Table 1

A tool to assess the quality of consultation and referral request letters

Consultation and Referral Request Letter Assessment Tool
Date of letter: ______________________________________
Discipline letter directed to: ________________________

A. Content
1. Patient demographics			YES	NO
2. Initial statement identifying the reason for the referral			YES	NO
3. Description of chief complaint			YES	NO
4. Description of associated symptoms			YES	NO
5. Description of relevant collateral history			YES	NO
6. Past medical history			YES	NO
7. Past surgical history			YES	NO
8. Relevant psychosocial history			YES	NO
9. Current medication list			YES	NO
10. Allergies			YES	NO
11. Relevant clinical findings			YES	NO
12. Results of investigations to date			YES	NO
13. Outline of management to date			YES	NO
14. Provisional diagnosis or clinical impression			YES	NO
15. Statement of what is expected from the referral			YES	NO
B. Style
16. One topic per paragraph			YES	NO
17. Paragraphs with fewer than 5 sentences			YES	NO
18. One idea per sentence			YES	NO
C. Overall appreciation
Letter unhelpful to consultant			Informative helpful letter
1	2	3	4	5