Our referral forms
Download our colleague referral form if you're nurse, midwife, nursing associate or another healthcare professional
Download our third-party referral form if you’re an organisation or person making a referral in their professional capacity where you have no employment relationship with the person you’re referring.
Download our self-referral form if you’re a nurse, midwife or nursing associate making a referral about yourself.
Making our forms accessible
We’re committed to making sure that our fitness to practise processes are accessible for everyone. If you’d like our information in another format or need us to make an adjustment, please get in touch with us on 020 7681 5248
Sending your referrals
Please send your completed forms to firstname.lastname@example.org
Emails are limited to 25MB each, so please send any large attachments in a separate email. You’ll receive an automatic response within seven days to confirm we’ve received your form and with a unique case reference number.
You can also post your referral form to us. You can find the postal address on the front of your form.
Sharing your referral
We might need to share your referral and any related information with the nurse, midwife or nursing associate, their employer and other relevant parties. This helps us deal with your concern, so please provide us with permission to do this on your referral form.
You can make a referral without agreeing to share this information, but we might still need to act on the information you provided and share it as a result. If this is the case, we’ll explain this to you in detail.
We might also need your permission for any healthcare provider holding relevant information about your referral like medical or nursing notes, to share this information to us for our investigation. Again, if this is something we need to do, we’ll contact you about this before we take any action.
You can still make a referral and be anonymous but you won’t receive updates on the progress of the investigation.
We respect patients’ confidentiality, so at public hearings, we try to keep identities anonymous by not using their name. A patient or their family can request to waive anonymity in the hearing. We want to make attending a hearing as comfortable as possible for all involved.
We might only need to see copies of the documents that you supply as evidence. But sometimes we need the originals if the case progresses to an adjudication committee.
We always hold any paperwork securely. When we send information onto a nurse, midwife or nursing associate, we warn them that the documents they receive are only to be used in connection with the investigation.
We might need to pursue additional information from others to deal with your concerns.