Clinical Referral

From a Consultant or GP not registered with Virtue

Refer for Remote Managed Care

Open to all patients

To make a Referral, please complete the following Referral Form.

Or call us on 0121 816 0425

Lines are open between the hours of 09:00 - 18:00 Monday - Friday, excluding Bank Holidays.

Details of the Referring Clinician & Patient

Profession of the Referrer

Name and title of the Referrer

First Name

Last Name

Title of the Referrer

Email of the Referrer

Phone number of the Referrer

(###)

###

####

Name of the organisation to which the Referrer belongs (if applicable)

Name of Patient being Referred

First Name

Last Name

Please confirm you have patient consent to share their personal information (if applicable)

I confirm that I have patient consent to share their information

Phone number of Patient

(###)

###

####

Email address of Patient

What is the primary condition that you want to have managed?

What are the primary objectives of the Remote Managed Care?

Please add any further narrative to describe the objectives of the monitoring

Are they are other conditions that you would like us to be aware of?

What Remote Monitoring Plan do you consider most appropriate for the patient?

What period of Remote Monitoring do you consider most appropriate for the patient?

Do you you want us to contact you to discuss any of the following?

To discuss this Patient

To better understand Virtue Services

To understand how I can practice in the Virtual Hospital

To explore how I might work with Virtue for my other patients

How did you hear about Virtue?

Refer into our Urgent Acute Virtual Ward

Open on 5th November

What happens after submitting the Referral Form?

Following receipt our your Referral form a Member of our Client Services Team will contact the Patient and the Referrer (if this option has been selected) to understand the treatment objectives and to explain the Remote Monitoring Plan options and pricing.

Once we have understood the requirements we will provide the Patient with a Service Schedule and explain our Terms of Business, which can also be found here on our website. To support the Patient in considering the services, we will send a copy of the Service Schedule and Terms of Business to them and arrange a follow-up call, should they wish.

Once the Patient is ready to proceed, we will make record of their Consent, take payment and then onboard them onto the service.

The end-to-end process can be done within a matter of minutes, or at a slower pace should the Patient wish to have time to reflect on the decision and discuss with family members of the Referring clinician.