What is the proper procedure for writing an occupational therapy (OT) referral for a patient?

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How to Write an Occupational Therapy Referral

A proper OT referral should include the diagnosis, assessment findings, medical investigation results, follow-up plans, other professionals involved, and the specific reason for referral, ideally after you have explained the diagnosis to the patient. 1

Essential Components of the Referral Letter

Your referral letter must contain the following information:

  • Diagnosis: State the primary diagnosis clearly 1
  • Duration and laterality of symptoms: Specify how long the condition has been present and which side(s) are affected 1
  • Assessment findings: Include relevant clinical examination results 1
  • Results from medical investigations: Document any imaging, lab work, or other diagnostic tests 1
  • Follow-up plans: Indicate your intended monitoring schedule 1
  • Other professionals involved: List any other specialists or therapists currently treating the patient 1
  • Specific reason for referral: Clearly state whether this is for evaluation, treatment, or both 1

Common Indications for OT Referral

Refer to occupational therapy when patients have:

  • Disability affecting daily activities: Personal care, domestic tasks, childcare, community or leisure activities 1
  • Pain during activities of daily living: When pain impedes functioning and orthotics, assistive devices, or ergonomic adaptations may help 1
  • Hand/wrist involvement: Requiring hand therapy, splinting, orthoses, or compression 1
  • Need for care assessment: Determining care needs for people with disability 1
  • Environmental access difficulties: Problems accessing home, education, work, or community environments 1
  • Vocational needs: Support for employment, education, or voluntary roles 1
  • Pain, fatigue, mental health, or cognitive difficulties: When these impede activity engagement 1

Timing and Patient Preparation

Explain the diagnosis to the patient before making the referral 1. This is critical because:

  • Treatment is more likely successful when patients have some understanding and agreement with the diagnosis 1, 2
  • Patients should agree to the referral 1, 2
  • Patients need to understand that initial OT focuses on improving function, not just providing aids and adaptations 1, 2

What to Tell the Patient

When referring, explain to the patient:

  • Reason for referral: The patient is seeing an OT for evaluation and treatment planning, not necessarily just to receive equipment 1
  • What to expect: The evaluation will assess their functional abilities and may include recommendations for various interventions 1
  • Decision-making process: There are multiple management alternatives, and decisions will be made collaboratively 1

Minimum Written Information Required

Document in writing:

  • Duration of condition: How long the problem has been present 1
  • Laterality: Which side(s) are affected 1
  • Prior testing results: Include any hearing tests, tympanometry, or other relevant assessments 1
  • Functional concerns: Suspected speech, language, or activity limitations 1
  • Developmental status: Particularly relevant for pediatric referrals 1

Pitfalls to Avoid

  • Insufficient information: Form letters containing structured information are superior to unstructured typed letters and ensure all necessary details are included 3
  • Unclear expectations: Failing to clarify whether you're referring for evaluation versus immediate intervention creates confusion 1
  • Omitting context: Not providing the patient's history of the condition and general medical status limits the OT's ability to tailor treatment 1
  • Poor communication: Lack of clear documentation between referring clinician and OT leads to fragmented care 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Diagnosing and Treating Functional Neurological Disorder (FND)

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Referral letters: are form letters better?

The British journal of general practice : the journal of the Royal College of General Practitioners, 1997

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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