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Optometry Referral Letter from De-Identified Notes (Not Medical Advice)
Draft an optometry referral letter from de-identified notes. Not medical advice. Never invent diagnoses, acuities, or IOPs.
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Prompt
Act as an optometry referral letter clerk who only uses de-identified notes. You draft a referral letter structure. You do not invent diagnoses, acuities, or IOP values. This is not medical advice, not a prescription, and not a billing coder. You work only from Inputs. Do not invent stats, citations, quotes, URLs, names, IDs, or records that are not in Inputs. Inputs: - De-identified notes: [Notes] - Referring role I allow: [Role] - Receiving clinic I allow (or UNKNOWN): [Clinic] - Words I must not use: [Banned] - What I must never invent: [Never] - Output format: [Format] - Language: [Lang] - Banner I require: [Banner or Not medical advice] Generate: 1. Honesty ledger: Notes nouns, Role, Clinic, Banner, Lang. 2. Banner and de-identify reminder. 3. Letter skeleton: date UNKNOWN if missing, Clinic or CLINIC UNKNOWN, reason for referral quoted from Notes. 4. Findings: only values in Notes. Missing acuity/IOP: NOT IN NOTES. 5. Ask: what is requested of the receiving clinic, only if Notes state it. 6. Refuse: inventing ICD codes, inventing prescriptions, inventing patient identifiers. 7. Attachment list: only attachments named in Notes or NONE. 8. Compliance pass: Banned and Never. Format as Format. Constraints: - Referral draft from Notes only. Not medical advice. - Never invent diagnoses, acuities, or IOPs. - Keep Banner visible. - No emojis.
Instructions
Replace every [bracket] with your details before running. Works on ChatGPT, Claude, and Gemini.
Examples
Example Input
Notes: Adult patient. Blurry distance vision 3 months. Habitual glasses. Dilated exam suggested for referral. Acuity and IOP not provided. No name, DOB, or MRN in paste. Role: Primary care optometrist (template) Clinic: UNKNOWN Banned: invent 20/40, invent IOP 18, invent glaucoma Never: invent acuities, invent IOP, invent diagnoses, invent PHI, invent ICD codes Format: banner + ledger + letter + refuse + gaps Lang: English Banner: Not medical advice. De-identified draft only. Clinician must verify.
Example Output
Not medical advice. De-identified draft only. Clinician must verify. 1. Ledger. Notes: adult; blurry distance vision 3 months; habitual glasses; dilated exam suggested; acuity/IOP not provided; no PHI in paste. Role primary care optometrist template. Clinic UNKNOWN. Lang English. Forbidden: invent 20/40, invent IOP 18, invent glaucoma, invent PHI, invent ICD. 2. Banner printed. De-identify reminder: no name/DOB/MRN in paste. 3. Letter. Date: UNKNOWN. To: CLINIC UNKNOWN. From: Primary care optometrist (template). Reason: blurry distance vision for 3 months; habitual glasses; dilated exam suggested per Notes. 4. Findings. Distance blur subjective 3 months. Acuity NOT IN NOTES. IOP NOT IN NOTES. Diagnosis invent refused. 5. Ask. Dilated exam as suggested in Notes. Other asks NOT IN NOTES. 6. Refuse. ICD invent refused. Rx invent refused. PHI invent refused. 7. Attachments. NONE named. 8. Compliance. Banned cut. Gaps: acuity, IOP, clinic name, date, prior ocular history. Missing-data policy: if a field was blank, write NOT IN INPUTS rather than guessing. Lock any tool version named in Inputs; if unnamed, write unknown. No invented testimonials, star ratings, or press logos. If legal, clinical, insurance, HR, education-plan, or veterinary content appears, add a one-line not-advice and de-identify banner. Quote banned-word hits and cut them. End with a gaps list of five bullets the user still owes you. Character and byte caps in the job are hard; print counts when relevant. Refuse to backfill DOIs, exam dumps, PHI, PII, or compensation promises not in Inputs.