A study of 141 consecutive referrals from family physicians in four clinic sites was undertaken to obtain descriptive characteristics of the referral-consultation process and to identify factors associated with effective outcomes. Consultation reports were returned to referring physicians in 88 percent, 75 percent, and 43 percent of referrals from consultants in community practice, university faculty practice, and university outpatient clinics, respectively. The quality of the consultation reports, as determined by the referring physician's opinion, increased directly with the amount of referral information originally sent to the consultant. The referral-consultation process appears to be functioning well in this site. The data suggest that this process might function even better if referring physicians would personally contact and send letters to consultants.