Sample Medical Referral Letter to a Specialist

Sample Medical Referral Letter to a Specialist

[Below briefly describe on Sample Medical Referral Letter to a Specialist for operation or surgery. You can follow these sample as a letter to Hospital appointment for treatment. You can modify these sample as your requirement.]

Date…

The Head of Operations, (Doctor’s Designation)

Department Name…

Hospital name…

Sub: Letter for OT (Operation Theater) Booking Purpose

Respected sir,

My son/daughter visited you last week (date) and was diagnosed with brain cancer (Disease type), third stage. You advised us to consider an operation right away. However, upon further asking around I came to know that I will have to pre-book a bed in the operation theatre before it takes place. (Write actual situation). Sir, as you know that my son/daughter is in the last stage of cancer and needs to be operated upon desperately. (Write actual problem and situation). We can’t find any other nearby hospital thus I request you to kindly permit us and grant us a bed in the operation theatre.

The operation is scheduled to take place on the (date) of this running month and I would be really thankful if you yourself would conduct my daughter/son’s operation. I hope that you will understand my situation and consider approving my request.

Thanking you,

Your name…

Address…

Contact no. and signature…

 

Another format,

Date…

The Head of Administration, (Doctor’s Designation)

Department Name…

Hospital name…

Sub: Letter to Hospital for Treatment and Cabin Booking Purpose

Respected hospital administration head!

From the past few weeks I am feeling blinding pain (Disease or physical problem type) in my stomach and after that, there is a phase of dizziness where I feel I might almost lose my consciousness. (Describe your actual problem and situation). At first, I thought not much of it but now the intensity of pain is increasing every time it happens and it is affecting my everyday life routine.

I have sent my insurance to be renewed but it can take up to a week and I do not know if I can hold that in any longer so if you will please grant me a visit to the hospital and then you can bill me after the insurance comes I will be very grateful for you.

Regards,

Your name…

Address…

Contact no. and signature…