Referral letter I am writing to request home visits and further management of Mrs XXX. Who has been recovering from a shoulder replacement surgery and is being discharged today. Regarding Mrs XXX’s medical history, she has a history of right shoulder osteoarthritis and She has been experiencing severe shoulder pain and decreased mobility. On 11/07/2017, Mrs XXX was admitted to the hospital and diagnosed with right shoulder osteoarthritis and underwent right total shoulder replacement (TSR). Post operatively, her pain was managed with analgesics. During Mrs XXX’s hospitalization, her surgical site was monitored and assistance was provided to complete her daily activities. She was provided cold compress and shoulder-brace every 4 hours along with her neurovascular signs were observed. She was referred to a physiotherapist and educated about different exercises as per TSR Protocol. It would be appreciated if you could encourage Mrs XX to wear right arm sling for next 4 weeks and advise her to attend physiotherapy unit twice in a week and hydrotherapy sessions once every week. Kindly assist her to administer clexane subcutaneously for 4 days and please help her for showering. Please note, her surgical staples to be removed on 10 days post-operatively. Please note, her daughter will stay with Mrs Thompson for a month. Please do not hesitate to contact me for any further queries.