Send a Quick Message (QCKmsg)

Select an option *

Enter the Serial Number *

This can be found on referral documentation or interface

What is your Patient's NHS or Medical Record Number on the referral? *

Their Date of Birth? *

To which Hospital and Trust were they referred? *

To which Speciality or Service at that Hospital? *

Please type your message here *

Press SHIFT + ENTER to insert a line break. You can also cut and paste a radiology report here or attach files below

Upload an image or document file

What is your title? *

What is your first name? *

What is your last name? *

What is your grade? *

This is important information for specialists.

What is your bleep/ phone number? *

The specialist may need to contact you. The full number is more helpful (for example 0203 1234567 4321 is more helpful than 4321)

What is your personal mobile telephone number? *

Don't worry this will NOT be shared with ANYONE. referapatient will send you an SMS update when the specialist has responded
Please enter your mobile number with country code for example 447777123456 and not 0777712345

What is your email address? *

The latest response from the Specialist will be emailed. referapatient can only accept an organisation email address.

If you are not the supervising Consultant or Clinician for this patient please provide their email below

The latest response from the Specialist will be emailed. referapatient can only accept an organisation email address.

What type of alert to your mobile phone would you like to receive each time the specialist sends advice or a message?

SMS

Voice Call

At which Hospital and Trust are you? *

Your Speciality or Service at that Hospital? *

Send a Quick Message (QCKmsg)

Referral found!

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