- The beginning of the referral form has the criteria for referral. If you are unsure whether you should refer then please contact the team to discuss on 0800 0121 858
- Please complete the patient details fully
- The NHS number is important to us as we are unable to register the patient without this
- Within special requirements please identify to us any issues we may need to accommodate, such as language or access issues
- Diagnosis and presenting problem please include relevant items within the past 3 months or longer. Current medications are important so we are able to conduct a full assessment when we see the patient
- Spirometry results need to be within the past 12 months, and please attach a copy of the graph. This is to ensure that patients have an identified respiratory diagnosis by quality assured spirometry. If the patient has a non respiratory diagnosis this can be ignored
- The guidance notes at the beginning of the referral form assist in completing the rest of the form
- Reason for referral – more than one box can be ticked
- Referrer details – we will contact you if we are unsure or have further questions