The Ministry of Health has updated the content and procedure for filling out the referral form for medical care.

According to the order, fields have been added to the form for information about residence registration and temporary stay, as well as whether the patient resides in urban or rural areas. A separate section has been added for indicating the patient's employment status: whether they are employed, serving in the military, retired, a student, or temporarily unemployed. This information was not previously recorded.

Furthermore, the healthcare professional completing the document must now indicate the number of prescribed courses or cycles of treatment. New columns have also been introduced regarding the form, type, and conditions of medical care.

The updated form also allows for the inclusion of information about the medical insurance company, not just the compulsory medical insurance policy number. When issuing a referral electronically, information encoding, QR codes, and other identifiers are permitted. The document can be signed with an enhanced, qualified electronic signature of the physician through the institution's medical information system (MIS) or the state healthcare information system of the constituent entity of the Russian Federation.

When issuing a referral in paper form, all information is entered by the attending physician - a district physician, pediatrician, general practitioner, paramedic, obstetrician or specialized specialist.

In October 2025, the Russian Ministry of Health announced its intention to change the procedure for providing pediatric surgical care. The draft law added palliative care to the list of medical services, and expanded the list of conditions to include out-of-hospital care. The amendment also provides for the division of medical organizations into three groups based on the type of care provided.