Primary Care to Dermatology Referral Form

Streamline Dermatology Referrals with Paperform

When a patient needs specialized dermatological care, your referral process should be as efficient and thorough as the treatment itself. This Primary Care to Dermatology Referral Form template makes it simple for primary care providers to send comprehensive, complete referrals that help dermatologists hit the ground running.

Built for Healthcare Workflows

This template captures everything a dermatology specialist needs: detailed patient information, skin condition photos, symptom duration and progression, previous treatments attempted, and clinical recommendations including biopsy needs. Instead of incomplete faxed forms or endless phone tag, you can collect structured referral data that includes visual documentation—all in one professional, easy-to-complete form.

The form includes conditional logic to adapt based on the type of referral, urgency level, and whether a biopsy is recommended, ensuring providers only see relevant questions while maintaining clinical thoroughness.

Complete Patient Picture, Better Outcomes

With built-in image upload fields, referring providers can attach photos of skin conditions, helping dermatologists prioritize cases and prepare for appointments. The form captures medication history, allergy information, treatment timelines, and insurance details, reducing administrative burden on both the referring office and the specialist practice.

Automation That Works for Healthcare

Once submitted, this form integrates seamlessly with your existing healthcare workflows. Use Stepper to automatically route referrals to the appropriate dermatology department, create patient records in your practice management system, send confirmation emails to both provider and patient, and trigger appointment scheduling workflows. You can also set up notifications for urgent referrals to ensure time-sensitive cases receive immediate attention.

Paperform's secure infrastructure and data handling make it suitable for healthcare administrative workflows, helping you maintain professional standards while improving referral efficiency. With customizable success pages, you can provide referring providers with clear next steps and expected timelines, improving communication and patient satisfaction.

Whether you're a primary care practice managing dozens of specialist referrals monthly, a dermatology clinic looking to standardize intake from referring providers, or a healthcare network streamlining inter-provider communication, this template gives you a professional, efficient foundation that can be customized to match your specific protocols and branding.