Refer a patient to The Vesey

A quick online referral form for GPs, physiotherapists and other healthcare professionals. Submit the details below and we'll be in touch with the patient — track progress any time with the reference code you're given.

Prefer to refer by phone or letter instead? Call 0121 387 3705 or use your usual referral letter process — this form is simply a faster alternative.

About you

Your name

Your role

Practice / clinic

Search for a GP practice

Practice / clinic name

Practice email

Practice phone

Patient details

Patient full name

Patient email (optional)

Patient phone (optional)

Reason for referral

Clinical summary / reason

Urgency

For a genuine medical emergency, do not use this form — call 999 or advise the patient to attend A&E. For urgent same-day NHS concerns, 111.

Consent & declaration

I confirm I have this patient's consent to share their details with The Vesey, and that I am referring in a professional capacity. I understand The Vesey will process these details to arrange care in line with its privacy policy.

Track a referral

Already submitted a referral? Enter the reference code you were given to check its status.

Reference code