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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
Website
Refugee Health Assessment Template

A template to assist in performing the MBS Refugee Health Assessment from the Victorian Refugee Health Network. 

  • Suited for
    GP
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
Bet Safe self exclusion form

Use the BetSafe self exclusion form to request for self-exclusion from NSW clubs and hotels.

  • Suited for
    GP, Practice Nurse
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
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
Bankstown – Lidcombe Hospital Eye Clinical Referral

In the event of an emergency please direct your patient to the nearest hospital Emergency Department. If the patient requires an appointment within 4 weeks please ring Outpatients Reception Ph. 9722 8380 and ask to speak with the Ophthalmology Registrar

PDF (235 kb/ 2 Pages)
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
GP antiviral pre-assessment of aged care home residents form

This NSW Health pre-assessment must be completed by a doctor (preferably the resident’s regular GP), based on a discussion with the resident and/or the resident’s representative, before the resident tests positive for influenza or COVID-19.

  • Suited for
    GP, RACF
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