Dizziness/vertigo referral checklist

Urgency tier

• Same-day escalation for focal neurologic deficits, severe gait instability, or suspected central cause.
• Expedited referral for persistent disabling symptoms or recurrent episodes despite initial management.
• Routine referral for stable but unresolved dizziness requiring specialist assessment.

Minimum pre-referral workup

• Clarified symptom phenotype (vertigo, presyncope, disequilibrium, nonspecific dizziness).
• Orthostatic vitals, focused neurologic exam, and medication review.
• Baseline cardiovascular assessment where clinically indicated.

Referral packet checklist

• Symptom chronology and trigger patterns.
• Exam findings, objective measurements, and tests completed.
• Prior episodes, treatment attempts, and response.

Pre-referral optimization tasks

• Provide fall-risk precautions and activity safety guidance.
• Optimize hydration and medication contributors where possible.
• Arrange close interim follow-up and documented return precautions.

References

• Heart and Stroke Stroke signs (opens in a new tab)

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