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Date: 24 September 2021

Time: 23:22

Tertiary referrals

Referral forms are available to download below.

Are you using the Google Chrome browser?

If you are using Google Chrome, you must follow these steps to download and complete the referral forms:

  1. Click on the form you wish to use in the 'Downloads' section below. It will begin downloading.
  2. Once it has finished downloading, click on the arrow next to the downloaded file, then select 'Open with system viewer':

  3. The form will open. Complete all the required fields and then select 'Save' to save the file with the entered details or 'Email' to open your system's default email client with the completed form attached.

If you do not see the 'Open with system viewer' option, or the file does not open, you may need to install the Adobe Reader software on your computer first. This is available via the link below ('Get Adobe Reader').


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University Hospitals Birmingham NHS Foundation Trust is not responsible for the contents or the reliability of external websites and does not necessarily endorse the views expressed within them. Listing should not be taken as endorsement of any kind. We cannot guarantee that links to other websites will work all of the time, and we have no control over the availability of external web pages.

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