The written psychiatric consultation is the distillation, the official permanent record, and the one universal element of the consultation process. Both the document and process present a good and growing opportunity for service and teaching. The authors offer a conceptual and practical scheme to help potential consultants make decisions about the content, style, and wording of their written communications. Each of the components of the consultation document, including headings, openings, history, examination, and formulations, is considered in terms of its effects on the liaison with the consultee and the care of the patient.