Referrals
Headache referral checklist
Baseline assessment, red flags, and referral note elements for headache referrals.
Last reviewed 2026-01-05|neuro | headache | workup
Jump to
Minimum pre-referral workup
- Headache history including onset, duration, frequency, and triggers.
- Focused neurologic exam and vital signs, including blood pressure.
- Medication and caffeine use, including overuse of analgesics.
- Pregnancy test when appropriate.
- Review of prior imaging or emergency visits.
Urgency tier
- Thunderclap onset or worst headache of life.
- New headache after age 50 or with cancer/immunosuppression.
- Focal neurologic deficits, altered mental status, or seizure.
- Fever, neck stiffness, or signs of infection.
- Papilledema or progressive neurologic symptoms.
Referral packet checklist
- Headache phenotype (migraine, tension, cluster) and disability impact.
- Frequency, duration, and response to acute or preventive therapy.
- Neurologic exam findings and any abnormal vitals.
- Prior imaging results and dates if performed.
- Relevant comorbidities and medication list.
Pre-referral optimization tasks
- Limit acute analgesic overuse and document safe dose limits.
- Start or adjust first-line symptom plan while awaiting referral where appropriate.
- Reinforce return precautions for sudden severe headache or new neurologic deficits.