Before Changing Hospitals: Clarify the Purpose of the Referral and Who Will Take Responsibility for Your Care

If your doctor recommends changing hospitals, first ask your current care team to write down what they want the new team to address. Then confirm with the receiving hospital who will review your records, what type of appointment has been arranged, and who will manage your treatment while you wait. Having a referral letter or confirmation that your records were received does not mean admission or treatment has been arranged.

This guide is for patients and families preparing to seek care at another hospital, in another city, or in another country. If your condition is unstable, worsening rapidly, or you have critical symptoms, seek emergency medical help locally first; in mainland China, call 120. The clinical team must assess and coordinate whether and how you can be transferred, including acceptance by the receiving hospital, care during the journey, and the handover.[1][2][7]

Key Points

• Write the purpose of the referral as a specific question, such as “Please assess whether surgery is needed,” and keep any uncertainty about the diagnosis clear.
• Confirm separately whether records have been received, whether the clinical team has reviewed them, and whether an outpatient appointment or admission has been arranged. Each stage may have a different outcome.
• Before the new team explicitly takes over, agree with your current care team who to contact about medicines, follow-up checks, pending results, and changes in your condition. Do not stop medicines or change treatment on your own.
• If your condition is unstable, get assessed locally first and let doctors coordinate acceptance and transfer. Do not travel long distances on your own to make an appointment.

Clarify What the Referral Is Meant to Address

Ask your current doctor to explain why they recommend a referral and what options are available. Express your preferences once you understand them, and ask the team to explain anything unclear. If coordination is needed, ask whether your current hospital’s referral center or responsible department can help contact the receiving hospital. Ask your doctor whether the purpose is to clarify a diagnosis, get a second opinion, assess a particular treatment, or transfer ongoing treatment or rehabilitation to another facility. Also ask when the assessment should take place, whether you can travel safely, and what changes would mean you can no longer wait. If the diagnosis is uncertain, ask the doctor to retain “suspected” or any other original wording.[1][3]

You could ask: “What question do you want the new team to answer? Which treatments or tests should I continue until they respond?” If your current doctor recommends prompt care, tell the receiving hospital about that timeframe. If you cannot wait for a routine appointment, ask your doctor to help arrange an appropriate way to receive care.

Ask Your Current Team to Prepare a Summary and Records

Ask your current doctor to prepare a referral letter or clinical summary stating the reason for referral, your current condition, tests and treatments already completed, questions to address next, and the doctor’s contact details. Chongqing’s two-way referral form provides an example of how to record initial clinical impressions, medical history, and treatment to date. Forms required in other regions or for international referrals may differ.[3]

Prepare existing test reports and original medical images, pathology reports and descriptions of the materials, operation records, and discharge summaries as requested by the receiving hospital. List the medicines you are actually taking, their doses and how you take them, including over-the-counter medicines. Include allergies and recent medication changes. Keep originals and translations together, and identify the source of the translation. Ask both hospitals how to submit pathology slides or medical images; do not assume the receiving hospital can read them.[4]

If you cannot obtain a referral letter right away, you can still ask the receiving hospital whether you can request an assessment using your existing summary and which records must be supplied later. Ask your current hospital’s medical records department how to request records. Do not delay care your doctor considers urgent while trying to gather every document.

Confirm Progress and Arrangements with the Receiving Hospital

When contacting the destination hospital’s appointment or international patient department, first explain the referral question, the patient’s current location, and the timeframe recommended by the doctor. Then ask what records they accept and how to submit them securely. Confirm the campus, department, age range served, language support, and whether a referral letter is required. Tell the receiving hospital whether the patient needs mobility assistance, medical equipment, or infection precautions, and ask whether the hospital can arrange these. The clinical team must assess needs during the journey. For care in another city or country, also ask how long you may need to stay; the actual duration may change depending on test results. Save the receipt after uploading your records, but also ask:

1. Have you received them? Which documents have arrived, can the medical images be opened, and what is missing?
2. Who has reviewed them? Have they been sent to the relevant clinical team? Does that team need more records, recommend another department, or agree to arrange an assessment?
3. What has been arranged so far? For an outpatient visit, confirm the date, time, campus, department, registration process, and any conditions you must meet. If admission is being discussed, separately ask whether the receiving team, admission date, and bed have been confirmed.

Confirmation of an outpatient assessment alone does not mean surgery has been decided on or a bed reserved. Keep the specific responses. If there is no reply or records are incomplete, contact the appointment department through the method it provides, giving the submission date and any reference number that can help locate your request. Also inform your current doctor and discuss again whether waiting remains appropriate. The receiving hospital’s response determines its procedures and timeframes.[1][5]

You can copy this message: “My records were submitted on [date], under application number [if available]. Has the intended department reviewed them? What is still missing? Is the current confirmation for an outpatient assessment or for admission? If I need to submit more records, please tell me the secure submission method and when to contact you again.”

Who Will Manage Treatment and Follow Up Results While You Wait?

Ask your current care team to agree on a transition plan with you, preferably in writing:

• Who will arrange the next treatment, prescription, and follow-up checks, and on what dates; whether you have enough medicine until the next visit, and whom to contact if you do not.
• Which test results are still pending, who will review them, and when they will contact you; whom you should ask if results are still unavailable at the agreed time.
• Which symptom changes require prompt contact with a doctor and which require immediate emergency care; write down where to seek care locally and the phone numbers.
• Which doctor to contact to reconsider the plan if the appointment is delayed, the new hospital does not accept you, or the plan changes after testing.

Bring your current medication list and any medication changes instructed by your doctor to the new team, and ask them to check these against the original prescriptions. If the two teams’ advice differs, contact the prescribing doctor or the new team to clarify. Do not stop or add medicines, or change doses, on your own.[4][6]

Confirm the Handover Again Before Arriving or Returning Home

After your first visit, ask the new team to explain whether they are only providing advice, arranging further tests, or have agreed to take over a specific part of your treatment. If more tests are needed, note who will order them, who will review the results, the expected timeframe, and how to make contact. Share the conclusions with your current doctor.[5]

Before returning home after treatment, ask the treating team to write down medication changes, follow-up dates, rehabilitation or nursing care requirements, and situations that require contacting the specialist again. Where possible, ask your local doctor in advance to confirm whether they can take over prescriptions, tests, and follow-up care. List anything not yet confirmed by both sides as an outstanding task and agree on who will follow it up, including who will review abnormal or pending results and whom to contact if problems arise.[3][4]

Frequently Asked Questions

Does a referral letter guarantee a specialist appointment or admission?

No. Ask the receiving hospital to confirm separately the status of departmental review, appointments, and bed availability. If you only have an outpatient appointment, prepare for an outpatient assessment; do not treat it as a promise of admission or surgery.

Can I contact a hospital directly without a referral letter?

You can first ask the destination hospital whether it accepts inquiries from individuals and whether a referral letter is required for an appointment or by your insurance. Requirements differ between hospitals, services, and insurance policies. If a clinical summary is needed, ask your current doctor to help prepare it.

Will the two hospitals automatically share my medical records?

Do not assume the records have arrived or that the new team can open them. Ask both hospitals about transfer methods and any authorization required, keep your own copy, and confirm with the receiving hospital that all records have arrived and are readable.[1]

Whom should I contact if the receiving hospital asks for more records?

Ask the receiving hospital to list what is missing, the required format, and the submission method. Request reports, images, or pathology materials from the relevant departments at your current hospital. After submitting them, confirm again that they have been received and can be read, and ask when to contact the hospital about the review outcome.

What if I still have no appointment by the expected date, or my condition gets worse?

If you have not received a response about an appointment, contact the receiving hospital to check and inform your current doctor so they can decide whether arrangements need to change. If your condition changes significantly, contact your current care team promptly. If you have critical symptoms, seek local emergency help immediately; do not wait for an appointment response.

If the patient is unstable, can family members drive them to the new hospital themselves?

Have the local clinical team assess the patient first. Ask whether acceptance by the receiving facility, monitoring during the journey, and the mode of transport need medical coordination. For international transfers, also confirm arrangements with the clinical team, transport provider, and insurer, including a fitness-to-fly assessment, medical escort, ground transfers at both ends, and insurance authorization. In an emergency, seek help locally first. The mode of transfer is not determined by appointment status.[1][2]

Will costs and insurance automatically carry over after a referral?

First ask the receiving hospital about consultation and examination fees, any possible admission deposit, and payment methods. Check separately with the hospital and insurer whether direct billing is available, how much you must pay upfront, and the requirements concerning the hospital, referral letter, prior authorization, transport, and claim documents. Keep the referral letter, correspondence with the receiving hospital, responses, itemized invoices, and transport records. Coverage depends on the policy and the conditions confirmed by the insurer.

Who is responsible for follow-up after we return to our home country?

Before leaving, ask the treating team to write a follow-up and medication plan, and take it to your local doctor to confirm whether they can take over. If you have not yet found a doctor to take over, ask the treating team to help clarify interim arrangements and whom to contact with problems. Use the local emergency care system for emergencies.

Sources

Date checked: November 6, 2026. The policies and institutional procedures below each have their own scope of application. They do not guarantee that every hospital uses the same system or offers the same services.

1. National Health Commission: Notice on Strengthening First-Contact and Referral Services and Improving Continuity of Medical Care (2024). Requirements for referrals and continuity of care in Chinese medical institutions; ask both hospitals about actual arrangements.

2. Beijing Communications Administration: Information on Common Emergency and Public Service Numbers. 120 is the nationwide medical emergency number.

3. Chongqing Municipal Health Commission: Measures for Managing Referrals Between Medical Institutions (Trial) and Referral Forms. Examples of Chongqing’s referral system and forms; these are not nationally standardized forms.

4. World Health Organization: Medication Safety in Transitions of Care. Medication reconciliation and communication during handovers between care settings.

5. Royal Devon University Healthcare: What Happens to My Referral?. An example of review, waiting, and referral to other specialties at this UK institution; its waiting times and procedures cannot be applied to China.

6. World Health Organization: World Patient Safety Day Calls to Action and Key Messages. Recording medicines, tracking test results, and making contact after changes in condition.

7. World Health Organization: Acute Transfer Checklist. For professional teams to assess patients, arrange acceptance, and coordinate transfer handovers; the clinical team decides the specific plan.