Referral Letter
Date:
Dear Mr. XYZ
I am writing this letter to you on behalf of my patient Miss Glenda. She is my client and recently
gone through a psychometric test. She was referred to the psychological at sunrise hospital mental
health unit for assessment following the mental health act 2016. She was founded by the police
wandering in the street.
Hot family detail and social history are that she lives with her husband in Inverell. She is the
mother of two children name George and team. She was raised in rural Australia, where she is the
eldest sister in five children with three boys and two girls. She attended the local school and
gained an apprenticeship in a local bakery at the age of 14. She has a wide circle of friends in her
life where she recently retired and expressed feeling lost without the routine of attending work. In
context to her medical history, it is evident that she has a complicated medical high story until the
age of 55 years when she was given a diagnosis of hypertension and diabetes. She is not a smoker
and undesirable hustle on social drink where she reports consuming 4 to 5 standard drinks per
day. She recently goes through a psychometric test where the results are as follows.
The patient's MMSE score is below the cut-off score (23) that has been shown in clinical trials to
be the most successful in detecting dementia. As her performance is linked to persons of
comparable age and education level from the MMSE formal study, the likelihood of cognitive
dysfunction typical of dementia is further confirmed. She is facing difficulties in, Orientation to
Time, Orientation to Place, Comprehension, Reading, Writing, and Drawing.
Longitudinal Profile Record
01/01/2019 30/01/2020
MMSE (raw) 23 21
MMSE (T) 27 9
Consciousness Alert Alert
Orientation *3 Impaired
Attention/concentration n.a.d Impaired
Appearance Consistent with stated age Consistent with stated age
Eye contact Good Good
Dress Appropriate Appropriate
Grooming Adequate Dishevelled
Motor function n.a.d n.a.d.
Gait n.a.d. n.a.d.
Visual perception Impaired vision Impaired vision
Speech n.a.d. Word finding difficulties
Prosody n.a.d. n.a.d.
Auditory comprehension n.a.d. n.a.d.
Immediate memory n.a.d Impaired
Recent memory n.a.d. Impaired
Remote memory n.a.d. n.a.d.
Estimated intellectual
ability
Average Average
Executive functioning n.a.d. Planning and organization
deficits
Affect Flat Flat
Mood Apathetic Anxious

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