Jane Smith, MD.

Smith Primary Care

Smithville, MD 99999

Dear Dr. Smith: Thank you for your recent referral of Ms. Jen Jones for evaluation and treatment. I met with Ms. Jones initially today and we had the opportunity to discuss her reported difficulties with depression. I began my assessment of these difficulties and will continue this over the next two to three sessions. Once my initial assessment is completed I will be back in touch with you to provide you with my findings, recommendations, and our agreed upon treatment plan. I anticipate having this to you within the next two to three weeks.

(Insert patient’s relevant history and mental status examination here)

While no crisis or emergency exists at present, Ms. Jones’ depression is a serious concern. She understands that if her symptoms worsen she should contact me immediately. Despite the serious nature of Ms. Jones’ depression I am hopeful of being of assistance to her. I utilize a comprehensive treatment approach that will focus on reducing Ms. Jones’ distress and provide her with the skills and techniques to help her move forward quickly. I will work closely with you to ensure that Ms. Jones receives the best possible care and will keep you informed of her progress and all significant changes in her functioning as they occur.

I have enclosed several of my business cards for your use along with several pamphlets that may be of use to your patients. I am also separately sending you copies of a stress management tip sheet that I hope will be of value to your patients.

Once again, thank you for this very timely and appropriate referral. I very much appreciate the opportunity to be of service to Ms. Jones. Please feel free to contact me at any time if you have any questions or concerns about her treatment.

Sincerely,

Jeffrey E. Barnett, PsyD, ABPP

Licensed Psychologist

Board Certified in Clinical Psychology and in

Clinical Child and Adolescent Psychology