Referral Form Template
Streamline Your Referral Process with This Template
Struggling to gather referrals efficiently can hinder your business growth. This referral form template is designed for businesses looking to simplify the referral process and strengthen their networks. Capture essential information from referrers and referees effortlessly, track valuable leads, enhance your outreach efforts, and boost client acquisition-all while maintaining compliance with best practices. Try the live template and see how easy it is!
When to use this form
Use this template when partners, providers, or clients need to pass someone to your service with clear details. For example, a clinic sending a patient to a specialist can submit a Doctor referral form; a social worker connecting a family to food or housing can use the Social services referral form; and a care coordinator starting in-home support can send a Home care referral form. It is also helpful for programs that accept community submissions and want consistent information across sources. You capture the right intake data, consent, and contacts in one place. Your team routes cases faster, reduces back-and-forth, and tracks outcomes with less effort.
Must Ask Referral Questions
- Who is making the referral, and how can we reach you?
This identifies the source and gives you a reliable contact for follow-up. It also helps you verify credibility and close gaps if details are missing.
- Who is the person or organization being referred, and what are their preferred contact details?
Accurate names and contacts prevent delays and miscommunication. Preferences (phone, email, best time) improve response rates.
- Is this self-initiated or submitted by a provider or staff?
Knowing the origin shapes your next steps and tone. For self-directed cases, you can tailor intake using a Self referral form.
- What service, program, or specialist are you requesting?
Clear requests route the case to the right team on the first try. It also sets expectations about scope and timing.
- What supporting information or documents should we review (history, risks, notes, reports)?
Attachments and context reduce back-and-forth and support better triage. For workplace or school incidents, align with your Office referral form process.
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