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Templates and forms
My Care Partners referral form

Use this template to refer patients into the My Care Partners program.

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
Templates and forms
SWSLHD Voluntary Assisted Dying – Central Support Service Referral Form

For advice and information regarding the completion of this referral please contact the Voluntary Assisted Dying – Central Support Service on 8738 6055 between 8:30am to 4:00pm or email SWSLHD-VAD@health.nsw.gov.au

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
Templates and forms
Pulmonary Rehabilitation Program Referral Form

Pulmonary Rehabilitation is indicated for patients with chronic respiratory impairment who are dyspnoeic, have reduced exercise tolerance, or experience restriction to activities.

Your signature indicates that the patient is medically suitable to participate in exercise classes. Classes consist of a circuit of cardiovascular and strengthening exercises that are modified to each participant’s ability. Participants will be exercising for approximately 60 minutes a session with rest periods.

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
Templates and forms
GPMP 721 and TCA 723

Chronic Disease Management Preparation of a GP Management Plan (GPMP) (MBS Item No. 721) Sample Form.

Do not open this template in your internet browser. Download this template and save to your computer to avoid file corruption. 

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
Templates and forms
My Care Partners Notification of Case Conference

Use this template to notify the Care Coordinator of a pending case conference confirmation.

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
Templates and forms
Integrated Diabetes Care Case Conference Referral Form

Book a type 2 diabetes case conference to discuss patient management. Telehealth available.

  • Suited for
    GP
Templates and forms
My Care Partners early discharge or withdrawal notification

Letter to the MCP Care Enabler advising of a patient's withdrawal or discharge from the My Care Partners program.

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
Templates and forms
Metabolic Rehabilitation & Bariatric Program referral form

South Western Sydney Metabolic Rehabilitation & Bariatric Program at Camden Hospital.

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
Templates and forms
My Care Partners case conference invitation

Use this template to invite specialists/and or allied health providers to a case conference for the patient's Team Car Arrangement (TCA).

  • Suited for
    GP
Templates and forms
GP Mental Health Treatment Plan for Adults

Do not open this template in your internet browser. Download this template and save to your computer to avoid file corruption. 

This document is not a referral letter. A referral letter must be sent to any additional providers involved in this mental health treatment plan.

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
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