Osteoporosis/Fracture Prevention Service
Referral
(For Further Information See Overleaf)
Date of referral:
Patient Name:
Hospital No:
DOB:
Tel No:
Fracture – Wrist 
Humerus  Vertebrae  Other 
Reason for referral
Referred by (Please Print Name)______________________________
Signature_________________________________________________
Send to: Christine Heron
Osteoporosis / Fracture Prevention Nurse
Team 1 OPD, Queens Hospital, Rom Valley Way, Romford, Essex RM7 0AG
Contact Details:
Tel No. 01708 435000 ext 3219
Fax No. 01708 435118 (Please mark FAO Ms C Heron)
E-mail [email protected]
Chair: Dr Maureen Dalziel MD MBChB FFPH
Chief Executive: Matthew Hopkins
Factors which can be considered in Primary Care

Identify people who have had previous fragility fractures (hip, wrist, shoulder, pelvis
and spine) – these are fractures that have occurred with minimal trauma (e.g. a fall
from standing height)

Have osteoporosis risk factors been assessed?

If patient is > 75 years, start on weekly Alendronic Acid, please check calcium and
Vitamin D. Add Calcium & Vitamin D tablets - if the Calcium level is normal i.e. Adcal
D3 2 daily.

If concerns about oesophagitis or dental hygiene, use Strontium Ranelate provided
no history of DVT, Thrombo embolism, IHD or Stroke

If eGFR <30, avoid bisphosphonates / strontium and refer to metabolic bone clinic by
TSW.

Patients aged 50-75 years should be referred to the Fracture Prevention Service for
one-stop DEXA scanning (CAB or complete and send the referral on reverse).

Treatment dilemmas i.e. patients who continue to fracture despite anti-resorptive
treatment or patients with T scores on DEXA > -4.0 can be referred to the FPS or
Rheumatology.
Chair: Dr Maureen Dalziel MD MBChB FFPH
Chief Executive: Matthew Hopkins
Chair: Dr Maureen Dalziel MD MBChB FFPH
Chief Executive: Matthew Hopkins