At a glance
With our online referral confirmation system, you can refer your patients to specialists quickly and easily – without any additional administrative effort. This resource is particularly indispensable under the Visana Med Direct general practitioner model.
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Fill in the PDF template directly on a computer
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Save time, thanks to ease of use
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Download and print immediately
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Referrals under the general practitioner model can run smoothly
How referral confirmation works
In just a few steps, you can prepare legally valid confirmation of referral, which you can fill in, save and print, directly on a computer. This allows you to give your patients optimal support when referring them to specialists.
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Open the form or download it.
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The minimum requirements are that you provide the necessary patient data, state the reason for referral, and name the desired specialist. The referral date, stamp and signature are also mandatory. You are welcome to add comments in the space provided.
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Save the completed template as a PDF on your computer.
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Send the confirmation, by post or email, directly to the benefits centre responsible for your patient.
Our team will be happy to answer any questions you may have about using the form, or about the general practitioner model.
Frequently asked questions about confirmation of referral
We accept confirmations of referral from general practitioners until one year after the date of issue. If the specialist continues treatment beyond one year, we will require a new confirmation of referral.
No. Referrals must always be made by the chosen general practitioner. Accordingly, confirmations of referral can only be accepted if they have been issued by a general practitioner.
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