GP and Hospital Appointment Log
Every appointment in date order, with who was seen and where.
Health and medical records · HM-215 · Tracker
Free printable referral tracker — who referred you, to whom, the date, the appointment when it comes and the wait in days. PDF, Excel and browser versions.
2 pages. The A4 and US Letter files are laid out identically, so neither is shrunk to fit.
Print it and write on it
Fillable PDF type and save
Spreadsheet formulas included
The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.
The same sheet, on screen. Totals and figures are worked out as you type, rows can be added or removed, and you can print it or download the completed version as a PDF. Everything stays in your browser — your entries are kept in this browser's own storage on this device, nothing is uploaded, and there is no account.
A tracker for referrals, from the day one is made to the day something comes of it. Each row holds who referred you and to whom, the date it went, the urgency you were told, the appointment date once you have it, the wait in days and what the outcome was — so a referral cannot quietly go missing.
Anyone waiting on a referral, patients under more than one department at once, people chasing an appointment that has never arrived, and relatives or carers doing the chasing on somebody else's behalf.
The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The workbook uses plain formulas only — SUM, IF, COUNTIF and the like — so it opens in Excel, LibreOffice and Google Sheets without anything breaking, and every calculated cell is grey so you can see which figures it worked out.
Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.
No. It carries no target, no expected wait and no view about any figure on it. The days column subtracts one date from another, which is all it does.
Whatever word you were given, copied across. Different services use different terms and they mean different things in different places, so the sheet supplies none and simply records yours.
Because when a referral goes astray you have to go back to whoever made it, and months later nobody remembers which clinician that was. A name and a date settle it in one phone call.
Write that in the outcome column with the date and the reason you were given. A declined referral is one of the easiest things to lose track of, and the record of it matters at the next appointment.
Every appointment in date order, with who was seen and where.
Every test and scan in one dated list, with where it was done.
The questions you actually meant to ask, written down before you go.
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