Patient Referral

Referrals can be made via email (link^), healthlink (link), fax or our online portal below.
For urgent referrals and advice, please call 02 9956 7200

Please note: items marked: * indicate mandatory fields.

Referring Doctor Name

Referring Doctor Practice Name

Referring Doctor Provider

Referring Doctor Address

Referring Doctor Suburb

Referring Doctor State

Referring Doctor Postcode

Referring Doctor phone

Referring Doctor email

Patient First name

Patient Last name

Patient Date of Birth

Patient email

Patient phone

Patient clinical condition / details