The referral system constitutes an integral part of the family health model.Aim of study: to assess the present status of the referral system and how to improve it.Subjects and methods: this is across sectional study carried out at three family health units (FHUs) (Meet Al Attar, Sheblanga, Tahla FHUs) in Banha district at Qaliubya government, which were selected randomly. The evaluation of the referral system was according to the Minstery of Health and Population (MOHP) standards.The sample includes 110 clients who completed pre referral questionnaire, and 25 patients who came back with feedback and completed post referral questionnaire. All providers (two doctors and one nurse in each unit) in the three FHUs were asked to fill another questionnaire to assess their opinion about the referral system. Also the referral record (2011) of Meet Al Attar unit, and chronic cases records (diabetes, hypertension, and both diabetes and hypertension cases) were reviewed. The last referral form of each case of them; in 2011was evaluated for completion. Results of the study showed that; the majority of chronic cases were referred (91.7%). When it comes to the referral form it was found that the majority of the nurse part of the referral form was completed properly (94%), in comparison to the physician's part, only (66%) of vital signs were completed. It was also found that only (23.2%) of referred patients came with feedback, among whom, the findings of the examinations was the most completed item (69.2%). The most responding hospitals were fever hospital (30%) then educational and ophthalmological hospitals (23.4%& 24.2% respectively).It was revealed that, 37%, 40.8%, 57.1% of interviewed patients were previously referred from Meet El Attar, Sheblanga, Tahla FHUs respectively. Half of the referred patients (49.1%) mentioned the previous cause of referral to be fundus examination with or without lipid profile. Also (52.7%) were referred for fundus and lipid profile as the present cause for referral, and (64.5%) of patients were asked to do laboratory investigations in unit before referral. The patients' opinion about the services produced in the three units was (52.8%) very good.Conclusion: it is concluded that the referral system need strict supervision, training the providers, and explain the importance of the referral system and feedback.