Sample referral letters for doctors
Original model letter written for this site. Dates and names are fictional. Checked 11 Nov 2026.
Referral letter: Chronic kidney disease with persistent proteinuria: referral
Task: You are Mr Riad Shammas's general practitioner. Using the case notes, write a referral letter to Dr Heba Makhlouf, Consultant Nephrologist, Renal Outpatient Clinic, 26 Clinic Road, SW1A 2AA, requesting investigation of his chronic kidney disease and persistent proteinuria, with advice on further management.
3 November 2026
Dr Heba Makhlouf
Consultant Nephrologist
Renal Outpatient Clinic
26 Clinic Road
SW1A 2AA
Dear Dr Makhlouf,
Re: Mr Riad Shammas, DOB 18/02/1970
I am writing to refer Mr Shammas, a 56-year-old office administrator with chronic kidney disease and unexplained persistent albuminuria, to establish the cause and for advice on further investigations and renal protective treatment.
His eGFR has fallen from 58 in April to 54 in July and 51 mL/min/1.73 m² on 26 October. His urine ACR was 78 mg/mmol in July and 86 mg/mmol on an early-morning sample in October. Microscopy showed no haematuria, and cultures were negative.
He reports three months of foamy urine but has no oedema, dyspnoea, dysuria, visible haematuria, rash, joint symptoms or recent illness. Today his blood pressure was 128/78 mmHg. Ultrasound on 29 October showed normal-sized kidneys without hydronephrosis or cysts and no significant post-void residual. HbA1c was 36 mmol/mol, potassium 4.5 mmol/L and albumin 39 g/L.
He has no known diabetes, hypertension, family history of renal disease or drug allergies. He takes no regular medication and denies using NSAIDs, herbal remedies or bodybuilding supplements.
Serial results and the ultrasound report are enclosed. I will continue monitoring his renal function and blood pressure pending your review.
Yours sincerely,
General Practitioner
Body: 181 words
What it keeps: The trend matters more than any single result, so the three eGFR values and two ACR values appear together.
What it leaves out: Photography, the waiting-room chairs and the childhood tonsillectomy give a nephrologist nothing to act on.
Read the full case notes and write it yourself
What each paragraph does
- Purpose in one sentence: what is being referred and what the GP wants (cause, further tests, protective treatment).
- The trend, with all three eGFR values and both ACR values together, plus the findings that rule things out.
- Symptoms, examination, imaging and the other results a nephrologist would otherwise have to ask for.
- The negatives that matter: no diabetes, no family history, no NSAIDs or supplements.
- What is enclosed and what the GP will do while waiting.
Urgent referral letter: Urgent referral to a gastroenterologist: iron-deficiency anaemia and rectal bleeding
Task: Using the information in the case notes, write a letter of referral to Dr Anna Lindqvist, a gastroenterologist at Riverside Endoscopy Centre, requesting urgent assessment and colonoscopy. Address the letter to Dr Anna Lindqvist, Gastroenterologist, Riverside Endoscopy Centre, 140 Harbour Road, Northbridge.
21 October 2026
Dr Anna Lindqvist
Gastroenterologist
Riverside Endoscopy Centre
140 Harbour Road
Northbridge
Dear Dr Lindqvist,
Re: Mr Kevin Doherty, DOB 14/03/1965
I am writing to request urgent assessment and colonoscopy for Mr Doherty, a 61-year-old man with iron-deficiency anaemia and rectal bleeding.
He presented on 8 October with a three-month history of fatigue and breathlessness on stairs and an unintentional 6 kg weight loss over four months. For six weeks he has had looser stools two to three times daily, with occasional dark red blood mixed with the stool. His father was diagnosed with colorectal cancer at 68, and Mr Doherty has never had a colonoscopy.
On examination, he had pale conjunctivae and a heart rate of 92. His abdomen was soft without masses, and rectal examination revealed dark red blood but no palpable mass. Investigations showed haemoglobin 98 g/L, MCV 72 fL and ferritin 6 µg/L, with a positive iFOBT. Coeliac serology and renal and liver function were normal.
He has hypertension treated with perindopril and is allergic to penicillin. I have ceased his ibuprofen and commenced oral iron and regular paracetamol. He is anxious about the possibility of cancer. I will repeat his blood count and ferritin in four weeks.
Thank you for seeing him urgently.
Yours sincerely,
General Practitioner
Body: 187 words
What it keeps: Urgency is in the first line. The symptoms, family history and results that justify it follow in the order a gastroenterologist would look for them.
What it leaves out: Golf, hay fever, the appendicectomy, cholesterol, the neighbour's renovations and the television documentary do not affect the decision to scope.
Read the full case notes and write it yourself
What each paragraph does
- Urgency and the request (assessment and colonoscopy) in the first sentence.
- Symptoms and the family history that make the request urgent, in the order a specialist would ask.
- Examination and the results that justify the urgency, with units.
- Relevant history, allergy, what the GP has already changed, the patient’s worry and the GP’s next step.
- A short close that repeats the urgency without repeating the case.
What a medicine referral letter needs
- Purpose and urgency first Name the request, and if it is urgent, say so in the first sentence.
- Findings with units Give results and trends in the order the specialist will look for them, with units.
- Relevant negatives Say what is not present when it changes the work-up, such as no diabetes or no NSAIDs.
- What you have done and will do Treatment started or stopped, tests enclosed, your next review.
Write one yourself
Cover the sample and write from the case notes, then compare. There are 27 medicine referral tasks; here are the first few:
- Urgent referral to a gastroenterologist: iron-deficiency anaemia and rectal bleeding
- Urgent referral to a rheumatologist: suspected rheumatoid arthritis
- Urgent referral to a dermatologist: suspected melanoma
- Referral to a neurologist: first witnessed tonic-clonic seizure
- Referral to a paediatrician: faltering growth and chronic diarrhoea
- Urgent same-day referral to a cardiologist: exertional syncope in a young athlete
Free OET writing checker · Referral letter guide and template · All writing samples (PDF) · OET letter format
Questions candidates ask
How long should an OET referral letter for doctors be?
The body should be about 180 to 200 words. Relevance matters more than hitting an exact count: leave out anything the reader cannot use.
What goes first in an OET referral letter?
The purpose: who you are referring, to whom, and what you want them to do. The reader should know the request after the first sentence.
Can I use note form?
No. The task asks you to expand the relevant notes into complete sentences and use letter format. Dates, doses and results can be written as figures.
Is this the letter OET would mark as a perfect answer?
It is one good way to answer, written for this site. OET does not publish a single correct letter, and your own marks depend on the six Writing criteria.
Where can I practise writing one?
The bank has 27 medicine referral tasks with case notes; write one, then paste it into the free writing checker for an instant check.
Sources
Last checked . Rules and prices change: confirm on the official page before you book or apply.
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