Social Determinants of Health Referral Form

Addressing Social Determinants of Health Through Coordinated Care

Social determinants of health (SDOH) account for up to 80% of health outcomes, yet many healthcare providers struggle to connect patients with the community resources they need. This Social Determinants of Health Referral Form bridges the gap between clinical care and social services, enabling primary care providers, care coordinators, and community health workers to efficiently refer patients to housing assistance, food security programs, transportation services, and other upstream interventions.

Built for Integrated Care Teams

Whether you're part of a federally qualified health center (FQHC), accountable care organization (ACO), hospital system, or community health network, this template streamlines the referral process for patients facing barriers like housing instability, food insecurity, lack of transportation, or other social risk factors that impact health outcomes and increase healthcare utilization.

The form captures essential clinical and social information in one place, routes referrals to the appropriate community partners, and helps your team track interventions that address root causes of poor health—not just symptoms. With conditional logic built in, the form adapts to each patient's unique needs, asking relevant follow-up questions based on identified risk factors.

Why Paperform for SDOH Referrals?

Paperform makes it simple to create professional, HIPAA-aware referral workflows without IT support. The intuitive editor lets care teams customize fields for local resources, add your health system's branding, and embed forms directly into your EHR portal or patient management system.

Key features for healthcare teams:

• Conditional logic reveals housing, food, or transportation questions only when needed
• Calculations can prioritize urgent referrals based on risk scoring
• Integrations with your CRM, case management software, or Google Sheets for seamless tracking
• Custom notifications alert community partners instantly when a referral comes through
• Secure submission with SOC 2 Type II compliance and data residency controls

Need to automate the entire referral loop? Connect this form to Stepper to trigger follow-up workflows—send confirmation emails to patients, create tasks for care coordinators, update your EHR, and schedule check-ins with community health workers automatically.

Designed for Value-Based Care and Population Health

As healthcare moves toward value-based reimbursement models, addressing social determinants becomes not just good practice but essential strategy. This template helps document SDOH screening and intervention as required by CMS, state Medicaid programs, and quality reporting frameworks like HEDIS and CAHPS.

Used by care coordination teams, social workers, patient navigators, and community health programs nationwide, this referral form supports a truly integrated approach to whole-person health—connecting the clinical and social systems that shape patient outcomes.