Referral Forms

Anticoagulation Clinic

Cardiac Rehab (Word document 29Kb)

Community Intervention Team

Diabetes Referral Form (Word document 71Kb)

Early Arthritis Referral Form

Endoscopy Referral Form (Word document 103Kb)

GP allergy testing advice request form

Haemochromtosis Gene (HFE) Mutation Consent Form

Haemochromatosis Gene (HFE) Mutation Analysis

Heparin-Induced Thrombocytopenia (HIT) Screen Request Form

Kidney Disease Referral Form (Word document 41Kb)

Malaria (Word document 95Kb)

Memory Clinic Guidelines

Memory Clinic Referral Form

Memory Clinics in Ireland

OPD Appointment Follow Up (Word document 3Kb)

PET/CT Referral Form (Word document 40Kb)

PET/CT Referral Guidelines

Referral form for Adult Mental Health Services

Respiratory Assessment Unit Home Visit Referral Form

Respiratory Assessment Unit Pulmonary Rehab Referral Form

Respiratory Assessment Unit Referral Form

Spirometry Referral Form (Word document 14Kb)

Standard Patient Referral Form (Word document 35Kb)

Thrombophilia Mutation Analysis Consent Form (Word document 31Kb)

Thrombophilia Screen Request Form (Word document 80Kb)

TIA Referral Form

Online Referral Forms

St. James's Hospital and the National Healthlnk Project have introduced a number of online referral forms for GPs. The electronic forms currently available are:

  • Neurology
  • Suspected Breast Cancer
  • Suspected Lung Cancer
  • Suspected Prostate Cancer (in association with The National Cancer Control Program)
  • Suspected Upper Gastrointestinal Cancer (in association with The National Cancer Control Program)

The electronic referral forms allow GPs to provide more relevant information, enabling the consultancy teams to make a more informed decision, faster. GPs who refer Prostate patients online are guaranteed a response within 5 working days, while Neurology referrals are responded to within 7 working days. The system also reduces administration duties & costs and should eliminate the problem of missing referral letters.

The referrals are submitted via the secure HealthlinkOnline website. Currently all St. James’s GPs who are registered with The National Healthlink Project have access to the forms however those not yet registered can contact Healthlink on 01 8825606 or

Full training is available from the Healthlink team.

Cancer Guidelines and Referral Forms

Mouth, Head & Neck GP Referral Form

Tabacco Free Campus