---
title: Urgent Care to Neurosurgery Referral Form Template | Paperform
description: Professional neurosurgery referral form with Glasgow Coma Scale, CT scan results, and neurological assessment. Streamline urgent head injury referrals from urgent care to specialist teams.
url: "https://paperform.co/templates/urgent-care-to-neurosurgery-referral-form"
type: static
generatedAt: "2026-03-28T00:45:28.013Z"
---

[← Back to free form templates](/templates/)    ![Urgent Care to Neurosurgery Referral Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/urgent-care-to-neurosurgery-referral-form.png)
    [Preview](https://_preview.paperform.co/ai-template/urgent-care-to-neurosurgery-referral-form) [Use this template for free](/create?ai-template=urgent-care-to-neurosurgery-referral-form)    [Healthcare & Medical Forms](/templates/category/healthcare/) [Healthcare](/templates/industry/healthcare/) [Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Healthcare Administrator](/templates/role/healthcare-admin/)     About this free form template
When a patient presents with a head injury at urgent care, timely and accurate communication with neurosurgery specialists can be the difference between optimal outcomes and preventable complications. This **Urgent Care to Neurosurgery Referral Form** is designed specifically for urgent care centers, emergency departments, and primary care clinics that need to quickly and comprehensively communicate critical patient information to neurosurgical teams.

Built on Paperform's flexible platform, this template captures everything neurosurgeons need to make rapid triage decisions: patient demographics, mechanism of injury, Glasgow Coma Scale scores, vital signs, CT scan findings, neurological deficits, and clinical urgency indicators. The structured format ensures nothing is missed during high-pressure handoffs, while conditional logic adapts the form based on injury severity and imaging availability.

### Why healthcare providers choose Paperform

Healthcare teams across urgent care, specialty practices, and hospital networks rely on Paperform to replace outdated fax-based referrals and clunky EMR workflows. This form integrates seamlessly into your existing tech stack—send completed referrals to your EMR via webhooks, notify neurosurgery teams through Slack or SMS using **Stepper** (stepper.io), and maintain audit trails for compliance and quality improvement.

With SOC 2 Type II compliance and robust security controls, Paperform offers the trust and reliability healthcare operations demand, while giving clinical and administrative teams the autonomy to build and refine referral workflows without waiting on IT. Whether you're managing a single urgent care location or a multi-site network, this template adapts to your protocols and integrates with the tools you already use.

**Note:** Paperform is not a HIPAA-compliant solution. For organizations requiring HIPAA compliance, please evaluate alternative platforms that meet those specific regulatory requirements.
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