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Referral Forms

We are constantly adding to and updating this list. If there is something you would like to see included, please email us at practicesupport@ddwmphn.com.au and let us know.

Instructions for importing Referral Forms into Best Practice

Instructions for importing Referral Forms into Medical Director


Chronic Disease Referral Form (Formerly RPHS) Referred patients must utilise all other funding options prior to using Chronic Disease Program funding.
DDHHS - GP Information Folder This directory provides information regarding the services available at Toowoomba Hospital and how to refer to them. The DDWMPHN is working on developing .rtf file formats for integration with practice software. They will be uploaded here when available.
DDHHS EEG Request Form - PDF DDHHS EEG Request Form - PDF. RTF versions for Best Practice and Medical Director are currently being created.
DDHHS Gastrointestial Endoscopy Referral Form - PDF DDHHS Gastrointestinal Endoscopy Referral Form - PDF. RTF versions for Best Practice and Medical Director are currently being created.
DDHHS Geriatric Adult Rehabilitation And Stroke Service Garss Outpatient Referral - PDF DDHHS Geriatric Adult Rehabilitation And Stroke Service (GARSS) Outpatient Referral Form - PDF. RTF versions for Best Practice and Medical Director are currently being created.
DDHHS Mental Health Service Referral Form - PDF DDHHS Mental Health Service Referral Form - PDF. RTF versions for Best Practice and Medical Director are currently being created.
DDHHS Rapid Access Chest Pain Clinic Referral Form - PDF DDHHS Rapid Access Chest Pain Clinic Referral Form - PDF. RTF versions for Best Practice and Medical Director are currently being created.
DDHHS Rapid Access TIA Clinic Referral Form - PDF DDHHS Rapid Access TIA Clinic Referral Form - PDF. RTF versions for Best Practice and Medical Director are currently being created.
DDHHS Toowoomba Hospital Urology Service Referral Form - PDF DDHHS Toowoomba Hospital Urology Service Referral Form - PDF. RTF versions for Best Practice and Medical Director are currently being created.
DDWMPHN Mental Health Referral Form - Stepped Care - Best Practice RTF rtf. file for auto populating in Best Practice. PLEASE NOTE: You need to save the target on your drive and import into Best Practice before opening, otherwise the file will be corrupt, the fields will not be linked, and the template wont work.
DDWMPHN Mental Health Referral Form - Stepped Care - Medical Director RTF rtf. file for auto populating in Medical Director. PLEASE NOTE: You need to save the target on your drive and import into Medical Director before opening, otherwise the file will be corrupt, the fields will not be linked, and the template wont work.
DDWMPHN Mental Health Referral Form - Stepped Care - PDF Mental Health Referral Form for Darling Downs and West Moreton PHN Primary Mental Health Services delivered within the stepped care approach.
DVA Request This form should be used to: • request prior approval from DVA, where necessary, for treatment services and the supply of rehabilitation appliances; • refer directly to another provider where prior approval from DVA is not required; • request patient transport for travel to treatment services.
HealthWISE Indigenous Mental Health Referral Form This service provides targeted psychological therapy for Aboriginal and/or Torres Strait Islander people who are experiencing mild to moderate mental disorder. Clients referred under this program are those who would benefit from short-term interventions.
ITC Referral Form - Care Coordination and Supplementary Services - Best Practice Integrated Team Care (ITC) GP Referral Form for auto-populating in Best Practice. PLEASE NOTE: You need to save the target on your drive and import into Best Practice before opening, otherwise the file will be corrupt, the fields will not be linked, and the template wont work.
ITC Referral Form - Transport and Practical Assistance Integrated Team Care (ITC) Referral Form - Transport and Practical Assistance
Lady Cilento Children's Hospital Best Practice Referral Form (RTF) Lady Cilento Children's Hospital Best Practice Referral Form (RTF)
Lady Cilento Children's Hospital Importing Instructions (PDF) Lady Cilento Children's Hospital Importing Instructions (PDF)
Lady Cilento Children's Hospital Medical Director Referral Form (RTF) Lady Cilento Children's Hospital Medical Director Referral Form (RTF)
Lady Cilento Children's Hospital Specialist Referral Form https://www.childrens.health.qld.gov.au/chq/health-professionals/referring-patients/referral-forms/
Lady Cilento Children's Hospital ZedMed Referral Form (RTF) Lady Cilento Children's Hospital ZedMed Referral Form (RTF)
Mental Health Client Consent Form Replaces ATAPS Consent Form
Mental Health Consent Information Sheet By signing the Mental Health Client Consent Form you consent to the information contained within this information sheet
PFAS Claim Form Blood Tests Per- and Poly-fluoroalkyl Substances (PFAS) Claim Form - Pre and Post Blood Tests
PFAS Claim Form Mental Health Per- and Poly-fluoroalkyl Substances (PFAS) Claim Form - Psychological Therapies & Mental Health Services
Referral To Mater Adults Specialist Clinics Please see http://materonline.org.au/quick-referrals/refer-an-uninsured-patient/outpatient-clinic/outpatient-clinics-adult for Practice Software templates
SPOTON (Supporting Patient Outcomes through Organised Networks) - GP Discharge Summary SPOTON Supporting Patient Outcomes through Organised Networks GP discharge summary
Toowoomba Diabetes Service Referral Form Toowoomba Diabetes Service Referral Form - Credentialed Diabetes Educator (CDE) services, for the self-management of Diabetes
USQ Sport & Exercise Clinic Referral Form (PDF) USQ Sport & Exercise Clinic Referral Form (PDF)
West Moreton - Medical Director - Referral Form Instructions Instructions for importing templates into Medical Director (PDF)
West Moreton - Best Practice - Referral Form - RTF West Moreton - Best Practice - Referral Form (RTF)
West Moreton - Best Practice - Referral Form Instructions These are instructions for importing templates into Best Practice (PDF)
West Moreton - Medical Director - Referral Form West Moreton - Medical Director - Referral Form (RTF)
West Moreton - ZedMed - Outpatient Referral Form West Moreton - ZedMed - Outpatient Referral Form (RTF)
West Moreton - ZedMed - Outpatient Referral Form Instructions West Moreton - ZedMed - Outpatient Referral Form Instructions (PDF)
Zostavax Vaccine Consent Form Zostavax Vaccine Consent Form

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