NHS Referral Form

Refer your patients now for additional capacity in your hospital

Complete the form or call us on

0121 816 0425

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

Then complete the form with your details and objectives

Please use the appropriate referral form subject to if your patient is present with you or not. For that we have the following options:

If you are not with the patient that you wish to refer, or cannot specify a time, please select the following button instead.

If the patient is present first choose a slot below to secure an appointment that will be sent to the patient

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 & Acute Virtual Ward 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.