Referral Rejection Letter Template for Indonesia

The Referral Rejection Letter is a crucial document within Indonesia's healthcare communication system, used when a healthcare facility or provider needs to formally decline a patient referral from another medical institution. This document is essential when a facility cannot accept a referred patient due to various reasons such as capacity constraints, specialty limitations, or resource availability. The letter must comply with Indonesian healthcare regulations, particularly the Health Law (UU No. 36/2009) and relevant Ministry of Health regulations governing medical referral systems. It serves to maintain professional relationships between healthcare providers while ensuring patient care continuity through clear communication and alternative recommendations. The document typically includes patient information, rejection rationale, alternative suggestions, and necessary medical context, all while adhering to medical privacy requirements and professional standards.

1. Letterhead: Healthcare facility's official letterhead including name, address, contact information, and any relevant registration numbers

2. Date and Reference Number: Current date and internal reference number for tracking purposes

3. Recipient Details: Complete details of the referring healthcare provider/facility, including name, address, and any relevant registration numbers

4. Subject Line: Clear indication that this is a referral rejection response, including the patient's reference number if applicable

5. Patient Information: Basic patient details including name, medical record number, and date of referral (while maintaining privacy requirements)

6. Rejection Basis: Clear and professional explanation of why the referral cannot be accepted

7. Alternative Recommendations: Suggested alternative facilities or courses of action for the patient's care

8. Closing: Professional closing statement, signature block with name and credentials of the responding healthcare professional