Home Health to Wound Care Specialist Referral Form

Streamline Wound Care Referrals with Paperform

When a patient's wound requires specialist intervention, time is of the essence. This Home Health to Wound Care Specialist Referral Form template helps home health nurses, visiting nurses, and care coordinators submit complete, professional referrals that give wound care specialists everything they need to prioritize cases and prepare for consultations.

Why Home Health Teams Choose This Template

Home health nurses work independently in the field, often documenting complex wound care on the go. This template replaces faxed forms, scattered phone calls, and incomplete referrals with a single, comprehensive submission that captures:

• Detailed wound measurements and assessment using standardized clinical terminology
• Visual documentation through photo uploads that show wound progression over time
• Current treatment protocols including dressing types, frequency, and response to care
• Infection indicators and complications that help specialists prioritize urgent cases
• Complete patient context including medical history, medications, and mobility status

The result is faster specialist review, better-prepared consultations, and ultimately improved patient outcomes.

Built for Real-World Clinical Workflows

This form template is designed around how home health nurses actually work. Conditional logic guides nurses through the referral based on wound type and severity, showing only relevant questions. Required fields ensure no critical information is missed, while optional sections allow nurses to add context when needed.

Photo upload fields let nurses document wounds visually from their mobile devices, with support for multiple images to show wound progression or different angles. Dropdown menus use standardized wound care terminology, making it easy to describe wound characteristics, exudate levels, and tissue types consistently.

Because Paperform works beautifully on mobile devices, nurses can complete referrals right after patient visits while details are fresh, rather than waiting to return to the office.

Perfect for Home Health Agencies, Hospitals, and Care Networks

This template serves multiple healthcare settings:

• Home health agencies can standardize how nurses refer to partner wound care clinics
• Hospital discharge planners can facilitate seamless transitions to outpatient wound specialists
• Skilled nursing facilities can streamline referrals for residents needing advanced wound care
• Wound care centers can receive complete, consistent referral information from multiple sources
• Care coordination teams can track referral volume and outcomes across their network

Automate What Happens Next with Stepper

Once a referral is submitted, Paperform's integration with Stepper can automate your entire referral workflow. Set up workflows that:

• Route urgent referrals (suspected infections, non-healing wounds) to specialists immediately via SMS or priority email
• Create patient records in your wound care clinic's EMR or practice management system
• Notify care coordinators and schedule follow-up calls
• Log referrals in shared databases or Airtable for tracking and reporting
• Send acknowledgment notifications back to referring nurses with expected response times

This means referring nurses get confirmation their referral was received, specialists get timely notifications, and care coordinators can track every referral without manual spreadsheets.

HIPAA Considerations and Data Security

While Paperform itself is not HIPAA compliant, this template can be used as part of a HIPAA-compliant workflow when paired with appropriate BAAs and security measures from your organization. Many healthcare teams use Paperform for internal referrals within their covered entity, or as part of documented procedures that meet their compliance requirements.

Paperform is SOC 2 Type II certified, meaning your referral data benefits from enterprise-grade security, encryption, and access controls. You can restrict form access, set up SSO for your team, and control exactly where submission data flows.

For organizations requiring additional security layers, Paperform's integration capabilities let you route sensitive data directly into HIPAA-compliant systems like your EMR, rather than storing it long-term in Paperform.

Designed for Nurses, Specialists, and Care Coordinators

Whether you're a home health nurse documenting complex wounds in the field, a wound care specialist receiving referrals from multiple sources, or a care coordinator managing referral workflows across your network, this template gives you a professional, complete referral process that improves communication and patient care.

Trusted by healthcare teams worldwide, this template brings the same level of polish and functionality you'd expect from expensive healthcare software, but with the flexibility and ease-of-use that lets clinical teams own and customize their workflows without IT tickets.

Get Started in Minutes

Simply use this template, customize the fields to match your specific protocols and terminology, connect your notification preferences, and share the form link with your referring nurses. No coding, no complex software implementations—just a better way to manage wound care referrals starting today.