The FP17RN is a referral notice form used to explain why a patient has been referred.

When to complete an FP17RN

An FP17RN form must be completed when a patient is referred for:

  • advanced mandatory services
  • additional services
  • secondary care

You can use an in-house referral form, typed letter or send the details using a secure email instead of the FP17RN form.

View an example FP17RN on the NHS Business Services Authority (NHSBSA) website.

Where to get an FP17RN

If your practice is in England, use the Primary Care Support England online supplies portal (PCSE).

If your practice is in Wales, contact your Local Health Board.

How to complete an FP17RN

The FP17RN is a copy form with 3 sheets of paper, the top page is the original and two carbon copies.

The top copy of the form is given to the patient, the middle copy to the referral service where the patient will receive treatment, and the bottom copy must be retained with the patient's notes.