FORMAT

Name
Position
Location

Date (date of the exam) – consistent

RE: Title Full name of the patient, DOB/Age: Age is more preferred so you wont compute
anymore for the age

Dear Position (Dear Ms. Smith, if no name, Dear Nurse/Profession)

[Purpose] I am referring to your care (Name: Ms.Surname)…(Dx)…(purpose)

[Situation] What happened, what management was provided

[Action] Discharge/Referral plan (kindly, it would be) (Your further assistance)

[Goodbye] If you have any questions, please do not hesitate to contact me.

Yours faithfully,
Signature
Name
Position
Location