Information for professionals

How to make a written referral to the Adult Locality Services and Adult Specialist Teams:

  • Identify the service to which you would like to refer
  • Download the appropriate referral form
  • Email the referral form to the Referral Management Centre
  • EMIS summary to be generated and included with the referral 

Referring to our services

You will find information, including referral forms and guidance, to support you to refer into our services below.

For adult locality teams and specialist teams, you can contact our Referral Management Centre on 020 8296 4488 or email

There might be occasions where a service directs you to refer verbally: 

If this is the case:

  • Call our Management Referral Centre on 020 8296 4488
  • Provide the referral details requested by the administrator
  • You will be asked specific questions to clarify the service required for your patient and will be required to provide specific paperwork, which will be clarified at the time of the call
  • Email the required paperwork to within the timescale specified during the initial call before the referral can be accepted
  • EMIS summary to be generated and included with the referral,

Centre opening hours

Monday to Friday: 8am-6pm

Integrated Locality Teams: follow up enquiries

Follow up enquiries to discuss patients already on the caseload can be made to the Integrated Locality Team administrators. There is also a duty nurse available to speak to if required.

We are constantly aiming to improve the services that we provide and welcome any feedback on our referral process.

Referral forms

Before using these forms please make sure you have read the general referral instructions.

Integrated Post COVID Assessment Service Referral Form (Surrey).docx [docx] 130KB

Covid Oximetry @ Home service – Assessment Template).docx [docx] 79KB

Adult Dietitian Referral Form 2020.docx[docx] 72KB

Community Respiratory Nurse referral form 2020.doc[doc] 153KB

Pulmonary Rehab Referral form 2020.docx[docx] 157KB

Community HF form 2020.docx[docx] 134KB

Hand Therapy Referral Form 2020.docx [docx] 269KB

Podiatry Referral Form 2020.docx[docx] 826KB

SDHC Community Hub Referral Form Version 19 August 2020.doc [doc] 217KB

Tissue Viability Nurse Referral Form 2020.docx[docx] 145KB

SDHC Dietetics MSK and Podiatry Referral form Version 19 August 2020.docx[docx] 841KB

SDHC Specialist Nurse Referral Form Version 3 March 2020.docx[docx] 803KB