Industrial Clinic to Radiation Oncology Referral Form

Streamline Occupational Radiation Referrals with Paperform

For industrial clinics managing workers with occupational radiation exposure, referring patients to radiation oncology specialists requires detailed documentation, dosimetry records, and comprehensive exposure histories. This Industrial Clinic to Radiation Oncology Referral Form template provides a structured, compliant solution for healthcare providers working with nuclear medicine workers, industrial radiographers, and other radiation-exposed personnel.

Built specifically for occupational health physicians, radiation safety officers, and industrial clinic administrators, this template captures critical information including cumulative radiation exposure, dosimetry badge readings, cancer risk assessments, and occupational history—all in one professional, HIPAA-considerate form that integrates seamlessly with your existing healthcare workflows.

Why This Template Works for Industrial Healthcare

Unlike generic referral forms, this template addresses the unique needs of occupational radiation medicine. It includes fields for radiation source types, exposure duration, personal protective equipment usage, bioassay results, and specific cancer screening recommendations. The conditional logic ensures that only relevant sections appear based on exposure type and urgency, creating a streamlined experience for busy clinic staff.

With Paperform's calculation fields and conditional logic, you can automatically flag high-priority referrals based on exposure thresholds, route urgent cases differently, and ensure radiation oncology specialists receive complete information before the first consultation. The form can be embedded directly into your EMR portal or shared via secure links.

Automate Your Referral Workflow with Stepper

Take your referral process further by connecting this form to Stepper, Paperform's AI-native workflow automation tool. Automatically send referral notifications to radiation oncology departments, create calendar appointments, update patient tracking spreadsheets, and trigger follow-up reminders—all without manual data entry. Stepper helps industrial clinics maintain compliance documentation while reducing administrative burden on your clinical team.

Whether you're managing a small industrial clinic or a large occupational health department serving multiple facilities, this template provides the professional foundation you need to ensure worker safety and seamless specialist coordination.