Before Changing Hospitals: Clarifying the Referral Purpose and Responsibility for Your Care

If your doctor recommends changing hospitals, first ask your current care team to put in writing 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 that 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 life-threatening symptoms, seek emergency medical help locally first; in mainland China, you can call 120. The clinical team must assess and coordinate whether and how you can be transferred, including the receiving facility, care during transport, 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 retain any uncertainty in the diagnosis.
• 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 on medication, follow-up tests, pending results, and whom to contact if your condition changes. Do not stop medication 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 a long distance 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. Once you understand, share your preferences; 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 facility. Ask your doctor whether the purpose is to clarify a diagnosis, obtain a second opinion, assess a particular treatment, or move 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 the recommended 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 a preliminary clinical impression, medical history, and treatment course. Forms required in other regions or for international referrals may differ.[3]

Prepare existing test reports and original medical images, pathology reports and details of pathology materials, operation records, and discharge summaries as requested by the receiving facility. List the medicines you are actually taking, their doses and directions, including nonprescription medicines, along with allergies and recent changes. Keep originals together with translations and identify who provided 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 provided 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 appointments or international patient department, first explain the referral question, the patient’s current location, and the timeframe recommended by the doctor. Then ask which records they accept and how to submit them securely. Confirm the hospital site, 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. Needs during travel must be assessed by the clinical team. For care in another city or country, also ask how long you should expect to stay; the actual duration may change depending on test results. Keep the receipt after uploading records, but also ask:

1. Have the records arrived? Which files have been received, can the images be opened, and what is missing?
2. Who has reviewed them? Have they been sent to the relevant clinical team? Does the team need more information, recommend another department, or agree to arrange an assessment?
3. What has been arranged so far? For an outpatient visit, confirm the date, time, hospital site, 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 that surgery has been agreed or a bed reserved. Keep the specific response. If there is no reply or records are incomplete, contact the appointments department through the channel provided, giving the submission date and any reference number that can help locate your request. Also inform your current doctor and discuss again whether waiting is appropriate. Procedures and timeframes vary by hospital; follow the receiving hospital’s response.[1][5]

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

If a Planned Admission Has Been Discussed, What Else Should You Ask Before Departure?

An outpatient assessment, clinical agreement to admit you, and a confirmed bed may be separate stages. Check with the hospital’s admissions office or receiving ward: the hospital and site address, the department accepting you, the expected arrival date and entrance, and whether the bed is confirmed or still depends on test results, a deposit, insurance, or other conditions. Ask separately about your needs for a particular room type, an accompanying caregiver, accessibility, or medical equipment. Only the hospital can confirm the actual arrangements.

Compare the name on the patient’s identification with existing hospital registration, appointment, and insurance records. If an old identification document was used or the name is spelled differently, ask the hospital how to link and correct the records. Ask which records, medicines, and identification to bring, who will check your current medicines, and whom to contact at night or if you arrive late. Ask how the hospital will notify you and whom to contact next if bed availability changes, your flight is delayed, or pre-admission tests do not meet the requirements. Also ask your current doctor to reassess whether waiting and the care arrangements remain appropriate.

Verify deposits, approved services, your share of costs, and refunds for rescheduling separately with the hospital and insurer. Do not treat a guarantee letter or payment receipt as confirmation of a bed. Ask your current doctor to assess whether your condition allows this journey and what care you need during travel. If your condition suddenly worsens severely, seek emergency care immediately where you are; do not wait for the planned admission.[8]

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

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

• Who will arrange your next treatment, prescription, and follow-up tests, and on what dates; whether you have enough medicine until your next visit, and whom to contact if you do not.
• Which test results are 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 local care locations and phone numbers.
• Which doctor to contact to discuss a revised 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 the medication changes your doctor has instructed to the new team, and ask them to check these against your original prescriptions. If the two teams’ advice differs, contact the prescribing doctor or new team for clarification. Do not stop medicines, add medicines, or change doses on your own.[4][6]

Confirm the Handover Again Before Arrival or Returning to Local Care

After your first visit, ask the new team to explain whether they are only providing an opinion, arranging further tests, or have agreed to take responsibility for specific parts of your treatment. If more tests are needed, record who orders them, who will review the results, the expected timeframe, and how to make contact. Tell your original doctor the conclusions.[5]

Before returning to local care after treatment, ask the treating team to write down medication changes, follow-up test dates, rehabilitation or nursing needs, and circumstances that require contacting the specialist again. Where possible, ask a local doctor in advance to confirm whether they can take over prescriptions, tests, and follow-up. List anything the two teams have not yet confirmed as pending, and agree on who will follow it up. This includes 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 the department’s review, appointment status, and bed status separately. If you only have an outpatient appointment, prepare for an outpatient assessment; do not treat it as a commitment to admission or surgery.

Can I Contact a Hospital Directly Without a Referral Letter?

You can first ask the destination hospital whether it accepts direct inquiries from patients and whether a referral letter is required for appointments or insurance. Requirements vary by hospital, program, and insurance policy. If a clinical summary is needed, ask your current doctor to help prepare it.

Will the Two Hospitals Automatically Share Medical Records?

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

Whom Should I Contact If the Receiving Hospital Requests More Records?

Ask the receiving hospital to list the missing items, required formats, and submission channels. Request reports, images, or pathology materials from the relevant departments at your original hospital. After submitting them, confirm again that they have arrived, can be read, and when to contact the hospital about the review outcome.

What If I Still Have No Appointment by the Expected Time, or My Condition Gets Worse?

If you have not received an appointment response, contact the receiving hospital for an update and inform your current doctor so they can assess whether arrangements need to change. If your condition changes noticeably, contact your current care team promptly. If you develop life-threatening 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?

Have the local clinical team assess the patient first. Ask whether the receiving facility, monitoring during travel, and transport method 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 transport at both ends, and insurance authorization. In an emergency, seek help locally first. Appointment status does not determine the method of transfer.[1][2]

Will Costs and Insurance Automatically Carry Over After a Referral?

First ask the receiving hospital about consultation and examination fees, possible admission deposits, and payment methods. Check separately with the hospital and insurer whether direct billing is available, how much you must pay upfront, and 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 transfer records. Coverage is subject to 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 testing and medication plan, and take it to a 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

Checked on: 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 can provide 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 at medical institutions in China; 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 Referral Management at Medical Institutions (Trial) and Referral Forms. Referral rules and example forms for Chongqing; these are not nationally standardized forms.

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

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

6. World Health Organization: World Patient Safety Day Calls to Action. 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 hand over care during transfer; the clinical team decides the specific plan.

8. US CDC Yellow Book: Medical Tourism. Discuss complications and follow-up care with teams in both locations before travel; appointments and costs are subject to confirmation by the actual institution and insurer.