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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
Referral Guide Adult and Paediatric Chronic Pain Services form

Guide and referral form for GPs to request a chronic pain service referral from NSW Health.

  • 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
Templates and forms
Referral Intake Form Resilient Kid’s Clinics

Referral to SWSLHD's Community Paediatrics for comprehensive paediatric health and wellbeing assessment and management for several marginalised populations in South Western Sydney.
Send completed referrals to: Fax: 8738 4800 / Email: SWSLHD-ComPaedIntake@health.nsw.gov.au / Mail: Compaeds Intake - PO Box 3084 LIVERPOOL, NSW 2170. For all clinic enquiries, please ring (02) 8738 4844.

  • Suited for
    GP
View PDF
Word (Nov 2022)
Templates and forms
45-49 year old Health Check

Medicare Health Assessment for People Aged 45 to 49 Years Who are at Risk of Developing Chronic Disease.

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 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
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
Over 75 Health Assessment

Medicare Health Assessment for Older Persons (75+).

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
SWSPHN Clinical Suicide Prevention GP Referral Form

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
Templates and forms
Diabetes service referral form – Bankstown Hospital

GPs may refer a patient living in the Bankstown-Lidcombe hospital catchment area to a diabetes specialist for group education, individual allied health/nursing review, or a medical review using this form.
REFERRALS ACCEPTED VIA FAX ONLY 9722 8366

  • Suited for
    GP
  • Software type
    Best Practice, MedicalDirector
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