Once you've created a referral, this is where you'll spend most of your time communicating with recipients, sharing files and clinical notes, reviewing patient information, and keeping your team in the loop.
Step 1: The Referral Page Overview
Open a referral from the dashboard by clicking its row.
The toolbar at the top shows the status chip, urgency, ID, and a saving indicator when a save is in progress.
There are 4 tabs to help you manage the referral:
Messages: The main communication hub.
Files: A gallery of all attached documents and images.
Information: Patient, referrer, and recipient details.
Patient Letter: Where you create the formal letter for the patient (this has its own dedicated article see The Patient Letter.)
Step 2: The Messages Tab
The Messages tab is your main communication hub — a chronological feed of all referral activity. There are 5 types of content you'll see in the feed:
Messages: Text messages shared with the recipient (visible to both parties).
Notes: Internal notes for your team only. These are shown with an amber/yellow background and marked "Only visible to your team". Notes can be edited and deleted after posting.
Media: Images and files with thumbnail previews, grouped by who uploaded them.
Clinical Notes: Clinical notes attached from the patient's record, displayed with a Clinical Note badge.
Interactions: System-logged events like status changes and emails sent (shown with a green circle icon).
You can use the floating filter bar to show or hide specific types of content, which is handy for finding specific items in a busy referral.
Step 3: Sending Messages and Notes
At the bottom of the Messages tab, you'll find a rich text editor for composing your updates.
Type your content into the editor.
Use the Insert button to add document templates or patient documents — templates will automatically fill in patient and referral details.
Switch between Message and Note mode using the add mode selector:
Message: Visible to the recipient.
Note: Only visible to your team (private).
You can also enable Attach as PDF mode, which converts your content into a PDF and attaches it to the referral.
Step 4: Attaching Files
Click the attachment menu (paperclip icon) to see three options for adding content to the referral:
Upload File: Upload a file directly from your computer.
Patient File: Select images or documents that already exist in the patient's files in Principle.
Clinical Note: Attach clinical notes from the patient's clinical record. You can expand each note to preview its content before selecting it.
Step 5: The Files Tab
The Files tab provides a gallery view of all images and documents attached to the referral.
Files are grouped by who uploaded them (your team vs. the recipient), including names and dates.
Use the context menu on each file to Copy to patient files (if not already there), Download, or Delete.
Click the Select button to enable batch mode, allowing you to select multiple files to copy, download, or delete all at once.
Step 6: The Information Tab
The Information tab is divided into three sections: Patient Details, Referrer Details, and Recipient Details.
Patient Details includes the patient's name, date of birth, primary contact, phone, email, and address.
The Phone, Email and Address fields in the Patient Details section have a visibility toggle. You can toggle these off to hide sensitive information from the external recipient when they view the referral.
Use the copy button to copy all details to your clipboard for use elsewhere.
Step 7: Following a Referral
Anyone following a referral receives notifications for updates like new messages, replies, or status changes.
Click the follow button in the toolbar.
The referral creator is automatically added as a follower.
To add more followers, search for individual staff members or add an entire team at once.
Unread updates for referrals you follow are shown by a notification indicator in the sidebar.
On the dashboard, referrals with unread updates appear bold with a highlighted background.
Tip: Add your team leads or relevant specialists as followers so they stay informed of referral progress without having to check manually.
Conclusion: You now know how to communicate, share files, and manage information within a referral. Next, learn how to create and send a professional referral letter to the patient. Continue to The Patient Letter.
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