Primary Care to Medical Neighborhood Coordination Referral Form

Coordinate Care Across Your Medical Neighborhood with Paperform

When primary care physicians need to refer patients to specialists, the process often involves phone calls, faxed forms, and fragmented communication that can delay care and create gaps in patient safety. This Primary Care to Medical Neighborhood Coordination Referral Form transforms that experience into a structured, digital workflow that supports true team-based care.

Built specifically for primary care practices, multi-specialty groups, and accountable care organizations, this template helps you establish bidirectional communication channels with specialists from the moment a referral is initiated. You can clearly document the clinical reason for referral, share relevant history and test results, communicate care plan goals, and set expectations for consultation outcomes—all in one submission.

The form captures everything specialists need to provide timely, coordinated care: patient demographics, insurance information, clinical urgency, specific consultation questions, current medications, relevant diagnostics, and preferred communication methods for care plan updates. Conditional logic ensures that high-priority or complex cases surface the right details, while routine referrals move efficiently through your network.

Why Paperform works for healthcare coordination

Paperform gives healthcare teams the flexibility to design referral forms that match clinical workflows without IT support. You can embed forms directly into your EHR portal, send secure links via patient charts, or integrate submissions into your practice management system. SOC 2 Type II compliance and robust security controls mean you can trust Paperform with sensitive care coordination data (note: Paperform is not HIPAA compliant, so ensure your use case aligns with your organization's compliance requirements).

Once a referral is submitted, Stepper (stepper.io) can automatically route notifications to the specialist's office, update your CRM or care coordination platform, create tasks for care navigators, and send follow-up reminders to ensure loop closure. This eliminates the manual work of tracking referrals and ensures no patient falls through the cracks.

Built for value-based care and patient-centered medical homes

Whether you're part of a Patient-Centered Medical Home (PCMH), an ACO, or a multi-specialty network focused on value-based outcomes, this referral form helps you document and demonstrate care coordination. It supports quality reporting, reduces unnecessary specialist visits through clear clinical communication, and creates an audit trail for referral appropriateness and follow-through.

Medical directors, care coordinators, and clinical operations teams can use this template to standardize referral quality across providers, reduce variation, and build stronger relationships within their medical neighborhood. Get started with Paperform today and turn referral management into a competitive advantage for coordinated, patient-centered care.