This form is NOT intended to be used as a tool to find out where you are on the waiting list. Only the hospital you have been referred to will have access to that information.
Please do not use this form for radiology referrals or appointments.
Please be advised that you should contact the hospital to which you have been referred to discuss the progress of your referral prior to using this form.
This form is intended for use by patients who have been asked by the hospital / consultant to which they have been referred , to contact their GP to enable their referral to be accelerated.