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24 hour advice phone line:
0191 529 7108
(for patients and healthcare professionals only)

In patient care referral

If you need any help using our online referral system, please call the Referrals Team on
0191 529 7100

This page is for healthcare professionals to make patient referrals. The quickest and easiest way to make a referral is to use our online referral forms. However, if you would prefer to print off a form and send it to us by post or fax, you can download them using the links on each service listing below.

Online referral form

Who is making the referral?

Have you seen the patient in the last 24 hours?* (please click)

Yes No

Patient Details

Patient's Next of Kin

Medical Details

Is patient aware of diagnosis?

Yes No

Are family aware of diagnosis?

Yes No

Is patient aware of referral?

Yes No

Are family aware of referral?

Yes No

Key Worker

Other Teams Involved

Reason for referral

Advanced Statement in place?

Yes No