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Referral Forms

If you need assistance uploading referral forms into your medical software, please see instructions below:

Instructions for Medical Director MD

Instructions for Best Practice BP

Instructions for Zed Med

PHN Referral Forms

PHN Chronic Condition Services

PDF
MD
RTF

PHN Integrated Team Care CCSS

BP

PHN Integrated Team Care - Transport and Practical Assistance

RTF

PHN Poppy Centre Paediatric Program

RTF

Care finder program referral form

MD
BP
Darling Downs Health Referral Forms

EEG Request Form

PDF
RTF

Geriatric Adult Rehabilitation And Stroke Service (GARSS) Outpatient

PDF

Rapid Access TIA Clinic

PDF

Mental Health Service

PDF

QHealth Toowoomba Health Service

RTF

Referral to Cardiac Investigations Unit

PDF
RTF

Nurse/Midwifery Navigator Service Referral

PDF

Oedema Management Referral Form

PDF
West Moreton Health Referral Forms

Specialist Outpatient

PDF
MD
BP
ZedMed
RTF
Queensland Health Referral Forms

Queensland Health - Antenatal

MD

Queensland Children's Hospital Specialist Referral Form

MD
BP
ZedMed

Templates

Eating Disorders

GP Eating Disorder Plan

RTF
Mental Health

Mental Health Care Plan

RTF

Client Consent Form

PDF

Consent Information Form

PDF
Patient Subsidy Travel Scheme

Patient Registration Form A

RTF

Patient Registration Form B

RTF
PFAS

Blood Test Claim Form

RTF

Mental Health Claim Form

RTF
Pharmacy

Pharmacy Fax Template

RTF
Aboriginal and Torres Strait Islander

Infants and Preschool (birth - 5 years)

PDF

Primary school age (5-12 years)

PDF

Adolescents and young people (12-24 years)

PDF

Adults (25-49 years)

PDF

Older people (50+ years)

PDF

Last updated 26 February 2024