OET Referral Letter Guide
An OET referral letter asks another healthcare professional to assess, investigate or treat your patient. State the patient and your reason for referring in the first sentence. Then give only the case notes the reader needs, in order of importance, and end with a specific request. Keep the body of the letter to about 180–200 words.
On this page
What a referral letter does
In OET Writing you read a task and case notes, then write a letter to another professional. For most professions the letter is a referral, transfer or discharge letter. OET says you choose the content of all three in the same way: include what the reader needs to continue the patient's care. What makes a referral different is its purpose. You ask the reader to answer a clinical question, such as whether chest pain is angina, or to take on a task, such as starting physiotherapy.
Referrals are written in many professions. A GP might refer a patient to a cardiologist, a nurse might refer a patient to a dietitian, and a physiotherapist might refer a patient back to their GP. The method on this page works for all of them. For the full Writing task, including timing and the six criteria, read our OET Writing guide.
What to include
For each case note, decide whether the reader needs it to assess or treat the patient. If they don't, leave it out. The table shows how this usually works.
| Usually include | Usually leave out | Why |
|---|---|---|
| The main symptom, how long it has lasted and what makes it better or worse | Every symptom the patient has ever reported | The reader needs the problem you are referring, not the full history. |
| Abnormal results, and normal results that matter to your question | Long lists of normal observations | A normal ECG matters in a chest pain referral. A normal temperature usually does not. |
| Current medication, doses and allergies | Medication the patient stopped years ago | The reader may prescribe, so current medication must be accurate. |
| What you have already done and how the patient responded | Old conditions that have fully resolved | This stops the reader repeating treatment that did not work. |
| Social details that affect care, such as living alone | Hobbies, family members and jobs that don't affect care | Include a social detail only if it changes what the reader does. |
A paragraph plan
Case notes are usually in date order. Your letter should put the most important information first. This plan works for most referrals:
| Paragraph | What it contains | About how long |
|---|---|---|
| 1. Purpose | The patient's name, age and main problem, and what you are referring them for. | 1 sentence |
| 2. Current problem | Symptoms, how long they have lasted and the key findings. | 2–3 sentences |
| 3. Relevant background | History, risk factors, current medication and allergies that matter to the referral. | 2–3 sentences |
| 4. Management so far | What you have done, how the patient responded and any advice you have given. | 1–2 sentences |
| 5. Request | Exactly what you want the reader to do, and how soon. | 1 sentence |
Worked example: from case notes to letter
The case below is fictional and written by our team for practice. The clinical details are for practice only.
The case notes (shortened)
- Patient: Mr David Brennan, DOB 02/05/1963 (62). Retired teacher. Married, two adult children. Enjoys fishing.
- History: appendicectomy 1990. Hypertension since 2018, amlodipine 5 mg daily. No known drug allergies.
- Social: smoker, 20 cigarettes a day for 40 years.
- Family history: father had a myocardial infarction at 55.
- Today: 3 weeks of central chest tightness when walking uphill, settles within 5 minutes of rest. No pain at rest. BP 148/92 mmHg. Resting ECG normal.
- Plan: aspirin 75 mg daily and GTN spray as needed. Advised to call an ambulance if pain lasts more than 15 minutes or happens at rest. Agrees to referral to local stop-smoking service. Refer to cardiology, urgent.
Deciding what to keep
| Case note | Decision | Why |
|---|---|---|
| Chest tightness on exertion, settling with rest, no pain at rest | Keep | This is the reason for the referral. |
| Blood pressure and normal resting ECG | Keep | The cardiologist needs these findings to plan investigations. |
| Hypertension, smoking and family history | Keep | They are risk factors for the condition you suspect. |
| Amlodipine, new aspirin and GTN, no allergies | Keep | The reader needs current medication and allergies to manage the patient. |
| Safety advice and stop-smoking referral | Keep | They show what you have already done, so the reader does not repeat it. |
| Appendicectomy, job, family, fishing | Leave out | None of them changes the cardiologist's assessment. |
Model referral letter
The body of this letter is 185 words, inside the 180–200 target. The numbers match the notes below the letter.
-
Purpose in the first sentence
The reader learns who the patient is, the problem, the suspected diagnosis and that the referral is urgent, all before the second sentence.
-
Key findings, briefly
The pattern of the pain and the two findings the cardiologist needs are summarised. A normal ECG is included because it matters to the question.
-
Background grouped by reason
Risk factors and current medication sit together in one paragraph, so the reader can see the whole picture at once.
-
What has been done
Treatment, safety advice and the stop-smoking referral tell the reader what is already in place.
-
A specific request
The request says what to do and how soon. "Within the next two weeks" develops the purpose that the first sentence called urgent.
Opening sentences
OET says there is no single correct way to start a letter. What matters is that the reason for writing is clear from the first sentence. Change the wording to match the urgency and what you are asking for.
| What you need | Example opening |
|---|---|
| Urgent assessment | I am writing to urgently refer Ms Ali, a 34-year-old woman with sudden loss of vision in her right eye, for ophthalmology assessment. |
| Investigation | I am writing to refer Mr Tan, who has had unexplained weight loss of 6 kg over two months, for further investigation. |
| Treatment or therapy | I am writing to refer Mrs Grant, who is recovering from a right total knee replacement, for ongoing physiotherapy. |
| Advice on management | I am writing to request your advice on the management of Mr Reyes, whose blood glucose remains high despite two changes to his insulin. |
| A reader who knows the patient | I am writing to refer back your patient, Mrs Novak, whom you referred to our clinic in March, for continued care. |
Request sentences
The request is the last part of your clinical content. Make it specific, so the reader knows exactly what you are asking. A vague request, such as "Please see her", leaves your purpose underdeveloped.
- I would be grateful if you could assess her and advise on further management.
- I would appreciate it if you could review his medication and adjust it as you consider appropriate.
- Could you please arrange an echocardiogram and review him in your clinic?
- I would be grateful if you could see her within the next week, given her worsening symptoms.
Common referral letter mistakes
Starting with background
Before
Mr Brennan is a retired teacher who lives with his wife and has two adult children.
After
I am writing to refer Mr Brennan, a 62-year-old man with chest tightness on exertion, for urgent assessment of suspected angina.
The reader should know why you are writing from the first sentence. This is the core of the Purpose criterion.
Following the case notes in date order
Before
In 1990 he had an appendicectomy. In 2018 he was diagnosed with hypertension. Three weeks ago he developed chest pain.
After
Start with the chest pain, then give the history that explains it.
Organisation and Layout rewards putting the most important information first.
Leaving out what you have done
Before
Ending the letter after the symptoms and history.
After
I have started aspirin 75 mg daily and prescribed a GTN spray.
The reader needs to know current treatment to plan the next step and avoid repeating it.
A vague request
Before
Please see him.
After
I would be grateful if you could assess Mr Brennan within the next two weeks and arrange any further investigations you consider appropriate.
A specific request completes your purpose and tells the reader what to do.
Referral letter checklist
- My first sentence names the patient and says why I am referring them.
- If the referral is urgent, the letter says so.
- I included the findings the reader needs, including normal results that matter.
- Current medication, doses and allergies are accurate.
- I said what has been done so far.
- I left out notes that do not change the reader's assessment.
- My request says exactly what I want and how soon.
- The body of the letter is about 180–200 words.
Practise on OET Practice
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Write a letter under exam timing
Open Writing practice and choose a task for your profession. You get 5 minutes to read the task and case notes, then 40 minutes to write. A live word count shows your length as you type.
Open Writing practice -
Read your feedback
Writing and Speaking get AI-assisted feedback, reviewed by our team. Your practice grade and written feedback appear in your dashboard.
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Rewrite your weakest paragraph
Use the feedback to rewrite one paragraph, often the opening or the request. Then write a new letter with a different task.
Go to your dashboard
To see what each of the six criteria looks for, read OET Writing marking criteria in plain English.
Sources
- OET Writing sub-test (opens in a new tab) — OET (oet.com)
- Do you know the 3 OET letter types in the OET Writing sub-test? (opens in a new tab) — OET (oet.com)
- Study skills: assessment criteria (opens in a new tab) — OET (oet.com)
Written by OET Practice team. Last reviewed: 27 October 2026. Read our editorial policy .