Every TCF letter follows the same layout: the recipient's details, the date, a "Re:" line naming the patient, a salutation, paragraphs that each do one job, a closing, and your name and profession. Layout counts towards the Organisation and Layout criterion, and the right phrases help with Genre and Style. This guide gives you a layout template and a phrase bank you can adapt to any case.
TCF letter layout template
[Recipient's name]
[Position]
[Organisation]
[Address]
[Date, e.g. 16 September 2026]
Re: [Patient's name], [DOB or age]
Dear [Salutation],
[Opening paragraph: who the patient is and why you are writing]
[Body paragraphs: grouped by topic, most important first]
[Final paragraph: specific request and follow-up]
[Closing],
[Your name]
[Your profession]
Salutations and closings
| You know the reader's name | You do not know the reader's name |
|---|---|
| Dear Dr Lee, ... Yours sincerely, | Dear Sir or Madam, ... Yours faithfully, |
| Dear Ms Chen, ... Yours sincerely, | Dear Nursing Team, ... Yours faithfully, |
Use a title and surname (Dr Lee, Ms Chen), not a first name. For a letter to a patient or carer, use their title and surname too.
Useful phrases for the opening paragraph
- I am writing to refer [Mr X], a [age]-year-old [occupation], for assessment and management of [problem].
- I am writing to inform you of [Ms X]'s discharge home today following [procedure].
- I am writing to request your urgent review of [Mr X], who presented today with [problem].
- Thank you for seeing [Ms X], whom I reviewed today regarding [problem].
Useful phrases for the body
| To say | Phrases |
|---|---|
| How the problem started | He first noticed... / She presented with... / Over the past two weeks, ... |
| Findings | On examination, ... / Investigations showed... / There was no evidence of... |
| Treatment so far | She was commenced on... / His dose was increased to... / A wound swab has been sent. |
| Change over time | Despite..., his symptoms have worsened. / Her pain has since improved. |
| Relevant background | Of note, she... / His medical history includes... / He lives alone and... |
| Contrast | However, ... / Although..., ... |
Useful phrases for the request and closing
- I would be grateful if you could assess and manage...
- I would appreciate it if you could continue to monitor...
- Could you please arrange...
- A follow-up appointment has been booked for...
- Please do not hesitate to contact me if you require any further information.
Example: the same content, before and after
Pt c/o SOB on exertion 2/12, worse last wk. Ex-smoker. Sats 93% RA. CXR NAD. Pls see.
Mr Brown has had shortness of breath on exertion for two months, and it has worsened over the past week. His oxygen saturation today was 93% on room air, although his chest X-ray was clear. He is a former smoker. I would be grateful if you could assess him for possible chronic obstructive pulmonary disease.
The second version uses full sentences, explains the abbreviations, links findings with "although", and ends with a specific request instead of "pls see".
Format mistakes to avoid
- Mixing "Dear Dr Lee" with "Yours faithfully".
- Using the patient's first name only, or no "Re:" line at all.
- One long paragraph instead of paragraphs with one job each.
- Bullet points or headings inside the letter.
- Informal closings such as "Thanks" or "Regards".
See these phrases in a complete letter in the referral letter guide, or write your own and get criterion-by-criterion feedback in the Exam Hero question bank.
