Which piece of clinical information is required on a patient referral form?

• A. Insurance policy
• B. Diagnosis
• C. Date of birth
• D. Patient occupation

Answer: (B)

The key clinical detail a patient referral form must include is the diagnosis. This provides the receiving clinician with the exact medical reason for the referral, guiding what evaluations, tests, or treatments are appropriate and helping to ensure a smooth, coordinated plan of care. It tells the next provider what condition or concern needs attention and anchors the referral in the patient’s medical context.

Date of birth and other identifiers are important for matching records, but they’re not clinical information about the patient’s condition. Insurance details relate to billing rather than the clinical reason for referral, and occupation is usually not required unless it directly affects care.