New patients and new referrals can be entered from both Patient and Appointment book modules. They can also be automatically created when lab reports and referral letters are received in the HL7 format, and also when sub-contractors (using SPM) send electronic invoices.
If the patient is already in the database, and they are seeing another User for the first time for a new problem, the patient is not entered again – instead, a new referral is created to the User that they will see for treatment. It is therefore possible for a patient to have numerous referral entries if they are seeing the same, or different Users, for new episodes of care.

It is important to understand that there is a single, common list of patients that are shared and are available to all Users. But each User is not able to enter any clinical or financial records relating to the patient, until a referral entry has been made for them.

The most common method of entering new patients and referrals is when the appointment is being made.
'Quick Appointments' can be entered where the details for a new patient are known and entered, at the time of making the appointment, but no referral information is entered. This can reduce the time taken to make an appointment over the phone but does require the referral to be entered when the patient presents for their appointment.