Pain Management Clinic

Refer your patient

Caulfield Access is responsible for intake, information and referral processing for a wide range of community and ambulatory services. 

Only referrals from a General Practitioner or other medical specialist will be accepted.

We also welcome phone enquiries to discuss potential referrals or an existing referral. Referrals are triaged depending on priority. 

Patients requiring immediate assessment should be sent to the Alfred Emergency & Trauma Centre.

To refer a patient to the Pain Clinic either:

• Complete the Service Coordination Tool Template (SCTT) and submit electronically. 

or

• Complete and fax your SCTT referral form to Caulfield Access Unit.

Once a referral has been received, the access unit will phone the patient directly to discuss their needs and organise appropriate services.

Special referral instructions

Before making a referral to the pain clinic please consider the following eligibility criteria and discuss with the patient.

Eligibility Criteria includes:

• Clients over 18 years of age
• Experiencing persistent or chronic pain greater than 3 months in duration with symptoms that impact on daily activities including impact on work, study, and school or carer role
• Participated in an adequate trial of treatments in the previous 12 months (exercise and analgesia)
• At risk of functional or psychological deterioration, or medication dependence
• At risk of acute pain becoming chronic (for example Complex Regional Pain Syndrome or acute herpes zoster)
• Willing to explore living well with pain and is willing to learn to self-manage ongoing pain
• For patients outside the metropolitan area, consider whether they are willing and/or able to travel to attend the clinic on a regular basis for assessment and treatment.

We do not encourage referrals for only medication/prescription renewals

Prioritisation of referrals:

• CRPS < 3 months duration
• Repeated ED presentations
• At risk of job loss

All referrals require the following information:

Essential information:

• Referrer details and contact number
• Pain history: onset, location, nature of pain and duration
• Psychological status and cognitive function
• Details of previous pain management including the course of treatment(s) and outcome of treatment(s)
• Comprehensive past medical history, including mental health issues
• History of alcohol, recreational or injectable drugs or prescription medicine misuses
• Details of previous treatments and procedures
• Current and complete medication history (including non-prescription medicines, herbs and supplements)
• Copies of investigations

Additional information:

• Details of functional impairment
• Psychiatric history
• If the person has symptoms of, or have been diagnosed with post-traumatic stress disorder (PTSD)
• Details of current behaviours that may impact on the person’s ability to participate in a chronic pain management program (e.g. mental health issues, behaviours of concern, cognition issues, level of alcohol or other drugs intake)
• If person part of the vulnerable populations.