Referrals What would you like to do? I would like to request a referral I would like to track a referral Back Next Did you book the referral through NHS e-Referral? Yes No Back Next Was your referral to a local hospital? Yes No Back Next Referral Request Name * First Name Last Name Date of birth * - Month - Day Year Date Tel: * Email * example@example.com Named GP (if know) Who would you like a referral to? Why do you need this referral? Back Submit Next NHS e-Referral Tracking If your doctor has referred you to a specialist for further care you will be asked to book your appointment using the ‘NHS e-Referral’ system. You will receive a letter from us within 2 weeks giving details of how to book your appointment and any passwords you may need. To track your e-Referral you will need the following details to log into the e-Referral website: Your date of birth Reference number – this will be on the first page of your letter Password – this will be on the second page of your letter Further information Choosing from a list of hospitals or clinicsNHS e-Referral ServiceBook or change your Specialist Appointment online now Back Next Contact a local hospital Tees Valley Hospital Tel: 01642 087333 Church LaneAcklamMiddlesbroughClevelandTS5 7DX West Lane Hospital Tel: 03000132000 (ext. 2) Acklam RoadMiddlesbroughTS5 4EE2.2 miles away Back Next Track a referral Name * First Name Last Name Date of birth * - Day - Month Year Date Tel: * Email * example@example.com Who were you waiting to be referred to? Submit Should be Empty:
