We have a wide range of clinical resources available to our health professional community, including referral forms and referral guidelines.

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Resource Title Type
Allergy, Asthma & Clinical Immunology Referral Form (pdf 313 KB) Referral form
Bariatric Clinic Screening Assessment (pdf 411 KB) Referral form
Catheter Lab referral form (pdf 150 KB) Referral form
CH PCS Referral Form (pdf 28 KB) Referral form
Diabetes Clinic referral form (pdf 234 KB) Referral form
Health Assessment Questionnaire - CCHS (pdf 264 KB) Referral form
HIV Sub Acute Services referral form (pdf 178 KB) Referral form
Infant Child Youth Mental Health and Wellbeing Service Registration (pdf 315 KB) Referral form
Insulin Initiation Medication Referral form (pdf 516 KB)

For practitioners to complete

Referral form
Obesity Multidisciplinary Management Clinic - Assessments (pdf 296 KB) Referral form
Obesity Multidisciplinary Management Clinic – DASS 21 (pdf 283 KB) Referral form
Obesity Multidisciplinary Management Clinic – Health Questionnaire (pdf 266 KB) Referral form
Outpatient referral form (pdf 229 KB) Referral form
Pathology Request (pdf 193 KB) Referral form
PEG Clinic referral form (pdf 45 KB) Referral form
Post Acute Care referral form (pdf 182 KB) Referral form
Referral for Anorectal Physiology (pdf 94 KB) Referral form
Referral for Capsule Endoscopy (pdf 141 KB) Referral form
Referral for CAR-T Clinic (pdf 180 KB) Referral form
Referral for Clozapine Management (pdf 167 KB) Referral form
Referral for FDG PET Cognitive Decline (pdf 89 KB) Referral form
Referral for Gastrointestinal Endoscopy (pdf 275 KB) Referral form
Referral for Intestinal Ultrasound (pdf 142 KB) Referral form
Referral for Liver Fibrosis Ultrasound Inc Fibroscan (pdf 167 KB) Referral form
Referral for MRI Breast (pdf 45 KB) Referral form
Referral for MRI Cardiac (pdf 130 KB) Referral form
Referral for MRI Prostate (pdf 126 KB) Referral form
Referral for Oesophageal Manometry 24hr pH Study (pdf 87 KB) Referral form
Referral for Radiology and Nuclear Medicine (pdf 181 KB) Referral form
Referral for Vascular Investigations (pdf 254 KB) Referral form
Referral for VEM admission (pdf 204 KB) Referral form
Referral for Voluntary Assisted Dying (pdf 196 KB) Referral form
Referral to Acquired Brain Injury Community Rehabilitation (pdf 352 KB) Referral form
Referral to Acquired Brain Injury Inpatient (pdf 549 KB) Referral form
Referral to Acquired Brain Injury Transitional Living Service (pdf 608 KB) Referral form
Referral to Better at Home (pdf 70 KB) Referral form
Referral to Burns Clinic (pdf 245 KB) Referral form
Referral to CDAMS (pdf 258 KB) Referral form
Referral to Gambling Minds (pdf 219 KB) Referral form
Referral to Heart Centre (pdf 269 KB)

For clinical assessment and cardiovascular investigations

Referral form
Referral to HIV Complex Metabolic Clinic (pdf 154 KB) Referral form
Referral to Hyperbaric Service Outpatient (pdf 1 MB) Referral form
Referral to Infant, Child, Youth Mental Health Wellbeing Service (pdf 226 KB) Referral form
Referral to Infectious Diseases - VICPhage (pdf 175 KB) Referral form
Referral to Lung Function Laboratory (pdf 263 KB) Referral form
Referral to Neurophysiology (pdf 155 KB) Referral form
Referral to Ophthalmology Clinic (pdf 285 KB) Referral form
Referral to PET Imaging (pdf 314 KB) Referral form
Referral to Sub Acute Services (pdf 238 KB) Referral form
Referral to Victoria HIV Mental Health Service (pdf 217 KB) Referral form
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