An OET Nursing referral letter needs purposeful language, not a memorized collection of formal phrases. The reader should quickly understand why the letter exists, what documented information matters now, and what action the fictional case notes request.
This guide is a language exercise. It does not decide whether a real referral is appropriate and supplies no clinical recommendation. Visit the OET vocabulary practice hub and Exam English hub.
State the purpose
Useful openings name both the document and its job:
- “I am writing to refer Ms Diaz for the review requested in the enclosed fictional notes.”
- “I am writing to provide relevant background before Mr Chen’s scheduled review.”
Do not write I am writing regarding the above-named patient and leave the reader to infer the purpose. Do not add urgent unless the case notes explicitly establish that status.
Organize, do not transcribe
Group notes by function:
- reason for writing;
- relevant background;
- recent documented change;
- current status;
- requested action.
Time markers such as initially, subsequently, since then, and at the time of writing clarify chronology. Causal connectors such as therefore require stronger evidence. After the appointment means later in time; because of the appointment asserts cause.
Control status verbs
- completed: “The information session was completed.”
- scheduled: “A review is scheduled for 28 September.”
- requested: “A review has been requested.”
- pending: “Confirmation remains pending.”
These forms are not interchangeable. A request is not an arrangement, and an arrangement is not a completed event.
Fictional transformation
Notes: Ms Diaz attended on 12 September; she reported difficulty understanding two notices; a plain-language explanation was provided; referral request sent to community service; acceptance not recorded; she enjoys jazz.
“I am writing to refer Ms Diaz to the fictional community service following her attendance on 12 September. She reported difficulty understanding two administrative notices, which were discussed in plain language. A referral request has been sent; acceptance remains pending at the time of writing.”
The paragraph excludes the irrelevant hobby and preserves the unresolved status. It does not recommend care. For the general workflow, see OET case notes to letter vocabulary and OET referral-letter vocabulary.
Let purpose control selection
Before drafting, complete this sentence: The reader needs this letter in order to understand... The answer should come from the fictional task, not from your assumptions about real practice. A referral letter about communication support may need the person’s stated difficulty, relevant previous explanation, current administrative status, and the exact request. It may not need unrelated social details or every earlier contact.
Apply a three-question relevance test to each note:
- Does it explain why the letter is being written?
- Does it help the named reader interpret the current situation?
- Does it support the action explicitly requested in the task?
A note need not pass all three tests, but it should pass at least one. Enjoys jazz fails in the Ms Diaz example because it changes neither purpose nor communication status. Prefers written reminders could pass if the receiving service needs to communicate with her.
Relevance is contextual. Never memorize a rule that hobbies are always irrelevant or family information is always relevant. The purpose and reader decide.
Create a precise opening
A useful opening usually contains the writer’s act, the person, and the letter’s purpose:
“I am writing to refer Ms Diaz for the communication review requested in the enclosed fictional notes.”
If a request is not yet a confirmed arrangement, avoid an opening that implies acceptance: I am writing regarding Ms Diaz’s forthcoming review. Forthcoming presupposes the review will occur. The more defensible phrase is the requested review.
Compare these openings:
- too vague: “I am writing about Ms Diaz.”
- too expansive: “I am writing to arrange all necessary support for Ms Diaz.”
- evidence-controlled: “I am writing to provide relevant background in support of the documented referral request for Ms Diaz.”
The last version tells the reader what document they are reading while respecting the request’s unresolved status.
Understanding is only the first step.
Lyra Practice helps you retrieve and use high-value workplace expressions in realistic situations until they feel natural.
Start a practice session →Group facts into paragraphs
Case notes are chronological fragments; a letter needs a reader-focused structure. A practical grouping is:
- paragraph 1: purpose and current communication need;
- paragraph 2: relevant background and documented changes;
- paragraph 3: present status and requested action.
Chronology still matters inside those groups. Use dates where they distinguish stages: On 12 September... The following day... At the time of writing... Avoid moving back and forth between dates merely to follow the order of the original notes.
Topic sentences can signal a paragraph’s function: Regarding her communication preferences,... or At present,... Do not overuse headings or list-like prose in the letter itself. Cohesion should come from the relationship between sentences.
Preserve agency and responsibility
Passive voice is useful when the actor is unknown or less important: A referral request was sent on 14 September. Active voice is clearer when responsibility matters: The community office has been asked to confirm receipt.
Compare:
- “Follow-up should be completed.” Who should act?
- “The fictional notes ask the community nurse to confirm the appointment date.” The responsible reader and action are clear.
- “Please ensure that the issue is resolved.” This promises a broad outcome and may invent the request.
- “Please confirm receipt of the attached summary.” This asks for a defined communication act, if the notes support it.
Use please or I would be grateful if... to make a documented request courteous, but remember that politeness cannot authorize new content.
Convert fragments without changing meaning
Fictional fragments often omit articles, subjects, and tense:
- two notices received → “Ms Diaz reported receiving two notices.”
- explanation given 12/9 → “The notices were explained in plain language on 12 September.”
- community service contacted → “The community service was contacted.”
- acceptance? → “Acceptance is not recorded.”
There may be more than one grammatical expansion. Choose the version that retains the note’s source. If the note does not say who received the notices, do not automatically name Ms Diaz. If it says client reports two notices received, attribution is essential.
Worked planning example
Task: write to a fictional community liaison to provide background for a requested communication review.
Notes:
- Mr Evans contacted service, 11 September;
- says appointment messages use different locations;
- prefers telephone explanation, not email;
- staff member compared messages with him;
- clarification request sent to booking office, 12 September;
- no reply at time of writing;
- attended local concert in August.
Selection plan:
| Note | Include? | Reason |
|---|---|---|
| Different locations | Yes | Explains current communication need |
| Telephone preference | Yes | Helps the reader communicate |
| Messages compared | Yes | Records completed support |
| Clarification request | Yes | Establishes current status |
| Concert | No | No connection to purpose |
Draft:
“I am writing to provide relevant background for Mr Evans’s requested communication review. On 11 September, he reported that two appointment messages listed different locations and stated that he preferred a telephone explanation to an email. A staff member compared the messages with him. A clarification request was sent to the booking office on 12 September; however, no reply had been recorded at the time of writing. Please note Mr Evans’s stated communication preference when responding to the documented request.”
The final sentence does not prescribe care. It connects a supplied preference to a communication action.
Controlled editing practice
4. Notes say referral request sent; acceptance unknown. Choose the accurate opening.
A. “I am writing about the accepted referral.” B. “I am writing in support of the referral request sent for Ms Diaz.” C. “I am writing to guarantee a review.”
5. Which fact is relevant to a letter whose purpose is to explain a communication preference?
A. The client prefers telephone contact. B. The client enjoys jazz. C. The office walls are blue.
6. Which closing request names a defined communication action?
A. “Please do whatever is necessary.” B. “Please ensure a successful outcome.” C. “Please confirm receipt of the enclosed summary.”
7. Which sentence preserves an unresolved status?
A. “The service accepted the request.” B. “A request was sent, and acceptance remains unrecorded.” C. “The review took place.”
8. Which connector is safest when notes show only that one event happened later?
A. “therefore” B. “as a result” C. “subsequently”
Answers and rationales: 4-B, 5-A, 6-C, 7-B, 8-C. Answer 4 labels the event as a request. Answer 5 helps the recipient perform the letter’s communication purpose. Answer 6 requests a specific act rather than an outcome. Answer 7 keeps acceptance open. Answer 8 marks sequence without claiming cause.
Common phrase failures
- would be grateful if: acceptable when attached to a documented request; it cannot invent the request.
- for further management: vague unless the reader and purpose are clear.
- as soon as possible: a priority claim; use only if the notes support it.
- suffering from: often overstates or labels; report the source precisely.
- ensure: avoid promising an outcome outside the writer’s control.
Quick check
- Notes say “request sent.” A. “The referral was accepted.” B. “A referral request was sent.” C. “Care began.”
- Best purpose line? A. “I write about Ms Diaz.” B. “I am writing to provide the documented update requested before Ms Diaz’s review.” C. “Please do everything needed.”
- Which marks sequence only? A. because of B. after C. therefore
Answers: 1-B, 2-B, 3-B.
Sources
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