For healthcare professionals
Refer a patient
There are few different ways you can quickly refer a patient to Cromwell Hospital.
You can use the online form for referrals to consultants, download one of the pdfs below, or contact our dedicated referral service for GPs, Cromwell Direct. If you prefer, you can write a letter to refer your patient.

Patient referral
Use our online form to refer one of your patients to a consultant.
Download a PDF referral form for diagnostics tests and procedures.
- Audiology referral request form
- Breast care referral request form
- Cardiology referral request form
- Cardiology stress test referral request form
- CT scan referral request form
- Endoscopy referral request form
- Extracorporeal shockwave lithotripsy referral request form
- Extracorporeal shockwave therapy (orthopaedic) referral request form
- Extracorporeal shockwave therapy (Peyronies/ED) referral request form
- Fibroscan referral request form
- International Patient Centre referral request form
- Lung Centre referral request form (adult)
- Lung Centre referral request form (paediatric)
- MRI scan referral request form
- Neurophysiology referral request form
- Nuclear medicine referral request form
- Pathology referral request form
- PET/CT scan referral request form
- Prostate care referral request form
- Radiology referral request form
- Sleep Centre request form
- Therapy request form
- Ultrasound referral request form
- Vascular ultrasound referral request form
Get in touch
We can take your calls between 9am to 5.30pm, Monday to Friday.
Please note - regrettably we are unable to answer specific medical questions or offer medical advice via internet, email or telephone.