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Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Pathological headaches with large (>10mm) pituitary mass
    • Serum prolactin >x10 upper limit of normal range
  • Category 2
    (appointment within 90 calendar days)
    • All other cases of hyperprolactinaemia
  • Category 3
    (appointment within 365 calendar days)
    • No category 3 criteria

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Details of all treatments offered and efficacy
  • Duration of symptoms & associated symptoms
  • Plans re pregnancy if relevant
  • Serum prolactin with repeat level and measure macroprolactin if no symptoms
  • TFT (TSH, T4) creatinine and eGFR
  • 0800-0900 serum testosterone in men along with LH and FSH, SHBG
  • E2, LH and FSH results in women
  • ßHCG results in premenopausal women

3. Additional referral information Useful for processing the referral

  • No additional information

4. Request

Last updated: 13 June 2023