Search Resource Library

Liverpool Sexual Health Clinic Remote Consultation Request for Initiation of Hepatitis C Treatment

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

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

Do not open this template in your internet browser. Download this template and save to your computer to avoid file corruption. Mental health treatment plan review template developed by RACGP.

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

The NSW Menopause Initiative has established 4 severe and complex menopause hubs across NSW. Each networked Hub will provide clinical support for the remaining LHD across NSW. Where a referral is received that does not fall within the LHD catchment it will be redirected to the appropriate LHD severe and complex menopause service.
A multidisciplinary collaborative team approach will be utilised which may include access to a range of medical specialists (Endocrinology, Gynaecology, Rheumatology), allied health clinicians (Women’s Health Physiotherapy, Nutrition and Dietetics, Mental Health worker) and nursing as required and/or available.

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.

GPs and other practice staff may choose to gain iRAD consent verbally or in writing. 

If you choose to gain consent verbally, follow the steps and suggested script on this form when a patient has denied consent. Then save the template iRAD CONSENT DENIED into documents in the patient's medical record.  Name the record "iRAD Consent Denied".
This will remove consent. No information will be recorded for this patient from your current care location in iRAD.

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

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