Referral templates
Find referral templates for practice software below.
Ensure you follow instructions on how to open the templates.
For immunisation catch up templates please visit the Immunisation program for health practitioners page.
Statewide and National Forms and Templates
- Allied Health
- COVID-19
- COVID-19 Vaccination Consent Form RTF (285 KB) - Last updated 16/03/2022
- COVID-19 Adverse Event Following Immunisation Reporting Form RTF (149 KB) - Last updated 15/06/2021
- COVID-19 Vaccination Consent Form - 5 to 11 years Pfizer RTF (266KB) - Last updated 16/03/2022
- COVID-19 Vaccination Consent Form - 6 to 11 years Moderna RTF (262KB) - Last updated 16/03/2022
- DASS21
- DASS21 form RTF (19 KB)
- My Aged Care
- My Aged Care e-Referral Form – Quick Start Guide PDF (1.2 MB)
- My Health For Life
- National Bowel Cancer Screening
- GP Assessment Report RTF (154 KB)
- Veterans Affairs
- D904 Veterans' Affairs Request/Referral Form RTF (98 KB) - last updated 13/05/2022
- Allied Health
- COVID-19
- COVID-19 Vaccination Consent Form RTF (362 KB) - Last updated 16/03/2022
- COVID-19 Adverse Event Following Immunisation Reporting Form RTF (43 KB) - Last updated 15/06/2021
- COVID-19 Vaccination Consent Form - 5 to 11 years Pfizer RTF (222KB) - Last updated 16/03/2022
- COVID-19 Vaccination Consent Form - 6 to 11 years Moderna RTF (223KB) - Last updated 16/03/2022
- DASS21
- DASS21 Referral Form RTF (37 KB)
- DASS21 Scoring RTF (24 KB)
- My Aged Care
- My Aged Care e-Referral Form – Quick Start Guide PDF (2.5 MB)
- My Health For Life
- Veterans Affairs
- D904 Veterans' Affairs Request/Referral Form RTF (95 KB) - last updated 13/05/2022
- My Health For Life
- Allied Health
- Aboriginal and Torres Strait Islander Allied Health Services PDF (284 KB)
- Grouped Allied Health Services (Type 2 Diabetes) PDF (284 KB)
- Individual Allied Health Chronic Conditions PDF (50 KB)
- Children's Health Queensland
- COVID-19
- DASS21
- DASS21 referral form and scoring grid PDF (15.5 KB)
- Drug Arm
- Drug Arm referral from WORD (91 KB)
- Metro North Hospital and Health Service
- My Aged Care
- My Health For Life
- Referral Form PDF (342 KB)
- PEN CS Recipes
- National Bowel Cancer Screening
- National Bowel Cancer Screening GP assessment report PDF (202 KB)
- National Disability Insurance Scheme
- BUSHKids Referral PDF (567 KB)
- NDIS Access Request - Supporting Evidence Form PDF (244 KB)
- Paediatric Statewide Referral Criteria
- Patient Travel Subsidy Scheme(PTSS)
- Queensland Collaborative Virtual Integrated Pain Service
- Referral form PDF (1.1 MB) - Last updated 20/06/2021
- Queensland Influenza Vaccine Medical Exemption
- Queensland Pelvic Mesh Service
- The Queensland Pelvic Mesh Service offers comprehensive assessment and treatment for women with complications from pelvic mesh. Access to resources and referral forms is via the QPMS website.
- Secure Web Transfer and eHealth:
- STS AddressBook Individual Update Form PDF (390 KB)
This document is used for General Practitioners to update their information within the Queensland Health - STS (Secure Transfer Services) AddressBook for registration to the Health Provider Portal (HPP). - STS AddressBook Update Form PDF (410 KB)
This document is used for General Practices to update their information within the Queensland Health - STS (Secure Transfer Services) AddressBook for the delivery of Discharge Summaries and Clinical Letters.
- STS AddressBook Individual Update Form PDF (390 KB)
- Self-Management of Chronic Conditions service (SMoCC)
- Referral form PDF (82 KB)
- Statewide Cardiac Rehabilitation
- Statewide Cardiac Rehabilitation Referral Form PDF (217 KB)
- Statewide Renal Access Surgery
- Dialysis Access Referral PDF (140 KB)
- Veterans Affairs
Central Queensland
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC referral Yoonthalla Services (Woorabinda) RTF (111 KB) - Last updated 07/09/2020
- ITC Referral form Bidgerii RTF (175 KB) – Last updated 07/09/2020
- ITC Referral form Nhulundu (Gladstone and Banana) RTF (1.9 MB) – Last updated 07/09/2020
- Allied Health
- LiveBetter Referral Form RTF (146 KB)
- LiveBetter Referral Form PDF (258 KB)
- Alcohol and other drugs
- Lives Lived Well RTF (86 KB)
- Central Queensland Hospital and Health Service
- Alcohol and Other Drugs (AODS) PDF (826 KB)
- Breast Screen RTF (620 KB)
- Child and Youth Mental Heath PDF (287 KB)
- Clinical Measurements RTF (483 KB) - Last updated 31/08/2022
- COVID positive HiTH RTF (26 KB) - Last updated 01/02/2022
- Endoscopy RTF (172 KB)
- Maternity Booking In RTF (61 KB)
- Podiatry RTF (136 KB)
- Specialist Outpatient Department (SOPD)
- SOPD referral form - CQ wide RTF (108 KB) - Last updated 11/05/2021
- SOPD referral form - Emerald RTF (99 KB) - Last updated 11/05/2021
- SOPD referral form - Gladstone RTF (104 KB) - Last updated 11/05/2021
- Sub Acute Care and Chronic Rehabilitation (SACCR) RTF (130 KB)
- Early Pregnancy Assessment Service (EPAS)
- Referral form RTF (73KB) - Last updated 16/12/2021
- Investigations
- Lung Screen Australia X-ray Referral Form RTF (150 KB)
- Heart of Australia RTF (45 KB)
- Heart of Australia PDF (56 KB)
- Mental Health
- Stepped care mental health services
- PHN Mental Health Intake RTF (175 KB) - Last updated 20/05/2021
- Stepped care mental health services
- Specialist Palliative Care Rural Telehealth Service (SPaRTa)
- Referral form RTF (26 KB) - Last updated 27/08/2020
- Referral form PDF (49 KB) - Last updated 07/2020
- Flyer PDF (847 KB)
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC Referral form Yoonthalla RTF (77 KB) - Last updated 07/09/2020
- ITC Referral form Bidgerii RTF (113 KB) – Last updated 07/09/2020
- ITC Referral form Nhulundu (Gladstone and Banana) RTF (153 KB) – Last updated 07/09/2020
- Allied Health
- LiveBetter Referral Form RTF (115 KB)
- Live Better Referral Form PDF (258 KB)
- Alcohol and Other Drugs
- Lives Lived Well RTF (76 KB)
- Central Queensland Hospital and Health Service
- Alcohol and Other Drugs PDF (826 KB)
- Breast Screen RTF (620 KB)
- Clinical Measurements RTF (468 KB) - Last updated 31/08/2022
- Child and Youth Mental Heath PDF (287 KB)
- COVID positive HiTH RTF (18 KB) - Last updated 01/02/2022
- Endoscopy RTF (141 KB)
- Maternity Booking In Form RTF (43 KB)
- Podiatry RTF (115 KB)
- Specialist Outpatient Departments eReferral template
- SOPD referral form CQ wide RTF (107 KB) - Last updated 11/05/2021
- SOPD referral form Emerald RTF (98 KB) - Last updated 11/05/2021
- SOPD referral form Gladstone RTF (103 KB) - Last updated 11/05/2021
- Sub Acute Care and Chronic Rehabilitation (SACCR) RTF (111 KB)
- Colonoscopy/Gastroenterology
- CQHHS Endoscopy referral form RTF (141 KB) - Last updated 01/04/2020
- Early Pregnancy Assessment Service (EPAS)
- Referral form RTF (64KB) - Last updated 16/12/2021
- Investigations
- Lung Screen Australia X-ray referral RTF (110 KB)
- Heart of Australia RTF (11 KB)
- Heart of Australia PDF (56 KB)
- Mental Health
- Stepped care mental health services
- PHN Mental Health Intake RTF (140 KB) - Last updated 20/05/2021
- Stepped care mental health services
- Specialist Palliative Care Rural Telehealth Service (SPaRTa)
- Referral form RTF (19 KB) - Last updated 27/08/2020
- Referral form PDF (49 KB) - Last updated 07/2020
- Flyer PDF (847 KB)
- Mental Health
- Stepped care mental health services
- PHN Mental Health Intake ZIP (7.0 KB) - Last updated 20/05/2021
- Stepped care mental health services
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC Referral form Nhulundu (Gladstone and Banana) PDF (313 KB) - Last updated 15/01/2019
- ITC Referral form Nhulundu (Gladstone and Banana) WORD (514 KB) - Last updated 25/03/2020
- ITC Referral form Yoonthalla (Woorabinda) WORD (252 KB) - Last updated 16/06/2020
- ITC Referral form Bidgerii PDF (2.0 MB) - Last updated 09/072019
- ITC Referral form Bidgerii WORD (45 KB) - Last updated 05/12/2019
- Alcohol and Other Drugs
- Gumbi Gumbi Drug and Alcohol Awareness Centre PDF (373 KB) - Last updated 05/03/2021
- Allied Health
- LiveBetter Referral PDF (258 KB)
- Central Queensland Hospital and Health Service
- Alcohol and Other Drugs (AODS) PDF (826 KB)
- Breast Screen PDF (195 KB)
- Child and Youth Mental Heath PDF (287 KB)
- Clinical Measurements Gladstone
- Clinical Measurements Rockhampton RTF (56 KB)
- COVID positive HiTH RTF (8 KB) - Last updated 17/01/2022
- Endoscopy
- Rockhampton Referral PDF (24 KB)
- Pre-Procedure Screening Tool (258 KB)
- Hospital in the Home PDF (604 KB)
- Maternity Booking In PDF (1.0 MB)
- Nurse Navigator Service PDF (1.7 MB)
- Sub Acute Care and Chronic Rehabilitation (SACCR) Clinic Referral Form PDF (1.8 MB)
- Central Queensland Respiratory Diagnostics
- Respiratory Function Request Form PDF (1.3 MB) - Last updated 08/06/2021
- Early Pregnancy Assessment Service (EPAS)
- Referral form PDF (237KB) - Last updated 16/12/2021
- Investigations
- Lung Screen Australia X-ray Referral PDF (112 KB)
- Heart of Australia PDF (55 KB)
- Lung Screen Australia
- X-ray Referral PDF (112 KB)
- Mental Health
- Anglicare Central Queensland Referral (psychosocial program) WORD (1485 KB)
- Stepped care mental health services
- General Practitioner:
- PHN Mental Health Intake GP PDF (304 KB) - Last updated 20/05/2021
- PHN Mental Health Intake GP WORD (89 KB) - Last updated 20/05/2021
- Community (Non GP):
- PHN Mental Health Intake Community PDF (555 KB) - Last updated 20/05/2021
- PHN Mental Health Intake Community WORD (70 KB) - Last updated 20/05/2021
- General Practitioner:
- Mental Health Services in Residential Aged Care Facilities
- Lutheran Services - Wellbeing and Positive Ageing referral form WORD (37 KB) - Last updated 25/02/2021
- Specialist Palliative Care Rural Telehealth Service (SPaRTa)
- Referral form PDF (49 KB) - Last updated 07/2020
- Flyer PDF (847 KB)
- Telesleep Service
Wide Bay
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC Referral for Bundaberg RTF (95 KB) - Last updated 09/07/2019
- ITC Referral for Fraser Coast RTF (34 KB) - Last updated 31/07/2018
- ITC Referral for North Burnett RTF (507 KB) - Last updated 31/07/2018
- Fraser Coast Hospice
- Referral Form RTF (261 KB) - Last updated 2/11/2021
- HeartStart Cardiac Rehabilitation
- Referral form (1190 KB) - Last updated 10/02/2022
- Hepatitis C Treatment MDT
- SCHHS Hep C Referral RTF (22 KB) - Last updated 10/07/2017
- LungSmart Pulmonary Rehabilitation
- Referral form (121 KB) - Last updated 10/02/2022
- Mental Health
- Stepped care mental health service
- PHN Mental Health Intake RTF (175 KB) - Last updated 20/05/2021
- IWC Indigenous Stepped Care - Bundaberg RTF (210 KB) - Last updated 29/10/2020
- Stepped care mental health service
- Pulmonary Rehabilitation
- Pulmonary Rehabilitation Referral Form - Hervey Bay Physio RTF (117 KB) - Last updated 12/10/2018
- Queensland Collaborative Virtual Integrated Pain Centre
- Referral Template RTF (99 KB) - Last updated 03/02/2021
- Rural Primary Health Services
- RPHS Referral Template RTF (71 KB) - Last updated 8/11/2018
- SugarRight Diabetes
- Referral form RTF (32 KB) - Last updated 09/09/2021
- Specialist Palliative Care Rural Telehealth Service (SPaRTa)
- Referral form RTF (26 KB) - Last updated 27/08/2020
- Referral form PDF (49 KB)] - Last updated 07/2020
- Flyer PDF (547 KB)
- Vaccination History or Catchup
- WBHSS Referral Template RTF (23 KB) - Last updated 17/10/2018
- Wide Bay Falls Prevention
- WBHHS Fall Service BP - Last updated 13/12/22
- Wide Bay Hospital and Health Service
- Colonoscopy/Gastroenterology
- Colonoscopy/Endoscopy Referral Form RTF (63 KB) - Last updated 07/04/2022
- COVID
- COVID escalation of care RTF (27 KB)
- Integrated Care (HiTH/virtual ward) service
- Integrated Care service referral form RTF (22 KB)
- Request for Procedure form
- Specialist Outpatient Departments eReferral template
- WBHHS eReferral RTF (56 KB) - Last updated 15/09/2021
Updated to include Palliative Care - use this option if referring to SPACE service
- WBHHS eReferral RTF (56 KB) - Last updated 15/09/2021
- Colonoscopy/Gastroenterology
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC Referral for Bundaberg RTF (33 KB) - Last updated 04/07/2019
- ITC Referral for Fraser Coast RTF (28 KB) - Last updated 11/07/2018
- ITC Referral for North Burnett RTF (238 KB) - Last updated 31/07/2018
- Fraser Coast Hospice
- Referral Form RTF (86 KB) - Last updated 02/11/2021
- HeartStart Cardiac Rehabilitation
- Referral form (252 KB) - Last updated 10/02/2022
- Hepatitis C Treatment MDT
- SCHHS Hep C Referral RTF (33 KB) - Last updated 29 January 2019
- LungSmart Pulmonary Rehabilitation
- Referral form (104 KB) - Last updated 10/02/2022
- Mental Health
- Stepped care mental health services
- PHN Mental Health Intake RTF (140 KB) - Last updated 20/05/2021
- IWC Indigenous Stepped Care Mental Health Referral Form - Bundaberg RTF (175 KB) - Last updated 29/10/2020
- Stepped care mental health services
- Pulmonary Rehabilitation
- Pulmonary Rehabilitation Referral Form - Hervey Bay Physio RTF (116 KB) - Last updated 12/10/2018
- Queensland Collaborative Virtual Integrated Pain Centre
- Referral Template RTF (93 KB) - Last updated 03/02/2021
- Rural Primary Health Services
- RPHS Referral Template RTF (362 KB) - Last updated 8/11/2018
- SugarRight Diabetes
- Referral form RTF (209 KB) - Last updated 09/09/2021
- Specialist Palliative Care Rural Telehealth Service (SPaRTa)
- Referral form RTF (19 KB) - Last updated 27/08/2020
- Referral form PDF (49 KB) - Last updated 07/2020
- Flyer PDF (847 KB)
- Vaccination History or Catchup
- WBHSS Referral Template RTF (15 KB) - Last updated 17/10/2018
Wide Bay Falls Prevention -
- WBHSS Fall Service MD - Last updated 13/12/22
- Wide Bay Hospital and Health Service
- Colonoscopy/Gastroenterology
- Colonoscopy/Endoscopy Referral Form RTF (41 KB) - Last updated 02/12/2020
- COVID
- COVID escalation of care RTF (18 KB)
- Integrated Care (HiTH/virtual ward) service
- Integrated Care service referral form RTF (15 KB)
- Request for Procedure Form
- Specialist Outpatient Departments eReferral template
- WBHHS eReferral RTF (41 KB) - Last updated 15/09/2021
Updated to include Palliative Care - use this option if referring to SPACE service
- WBHHS eReferral RTF (41 KB) - Last updated 15/09/2021
- Colonoscopy/Gastroenterology
- Hepatitis C Treatment MDT
- SCHHS Hepatitis eReferral RTF (32 KB) - Last updated 30 January 2019
- Stepped care mental health services
- PHN Mental Health Intake RTF (130 KB) - Last updated 23/08/2021
- Wide Bay Hospital and Health Service
- Specialist Outpatient Departments eReferral template
- WBHHS eReferral RTF (8 KB) - Last updated 09/07/2021
- Specialist Outpatient Departments eReferral template
- Mental Health
- Stepped care mental health services
- PHN Mental Health Intake ZIP (7 KB) - Last updated 20/05/2021
- Stepped care mental health services
- Wide Bay Hospital and Health Service
- Specialist Outpatient Departments eReferral template
- WBHHS eReferral RTF (8 KB) - Last updated 09/07/2021
- Specialist Outpatient Departments eReferral template
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC Referral for Bundaberg PDF (133 KB) - Last updated 09/07/2019
- ADA Australia
- Bridges - New Psychological Support
- Referral form PDF (239 KB)
- Colonoscopy/Gastroenterology
- Colonoscopy/Endoscopy Referral Form PDF (426 KB)
- View on HealthPathways
- Fraser Coast Hospice
- Referral Form RTF (261 KB) - Last updated 2/11/2021
- Mental Health Services
- Mental Health Services in Residential Aged Care Facilities
- Lutheran Services - Wellbeing and Positive Ageing referral form WORD (37 KB) - Last updated 25/02/2021
- Stepped care mental health services
- PHN Mental Health Intake PDF (304 KB) - Last updated 20/05/2021
- PHN Mental Health Intake WORD (89 KB) - Last updated 20/05/2021
- Psychosocial Support program - IMPACT Community Services referral form (WORD) - updated 17/08/22
- Psychosocial Support program - Richmond Fellowship Queensland (RFQ) referral form (PDF) - updated 17/08/22
- Psychosocial Support program
- Bridges Intake Referral form (PDF) - Last update 17/08/22
- STEPS referral form (WORD) - updated 17/08/22
- Mental Health Services in Residential Aged Care Facilities
- Nurse Navigator Service
- WBHHS Nurse Navigator Service Referral PDF (1.9 MB) - Last updated 17/10/2018
- View on HealthPathways
- Persistent Pain
- Referral form
- Entry patient questionnaire PDF (336 KB) - Last updated 20/11/2017
- Rural Chronic Pain Self-Management Group PDF (95 KB) - Last updated 18/07/2018
- View on HealthPathways
- Pulmonary Rehabilitation
- View on HealthPathways
- Pulmonary Rehabilitation Referral Form - Hervey Bay Physio WORD (44 KB) - Last updated 12/10/2018
- Pulmonary Rehabilitation Referral Form - Hervey Bay Physio PDF (154 KB) - Last updated 12/10/2018
- Space Nurse (Specials Palliative Care in Aged Care)
- Bundaberg RTF (368 KB)
- Fraser Coast RTF (368KB)
- SugarRight Diabetes
- Referral form RTF (32 KB) - Last updated 09/09/21
- Ophthalmology
- Ophthalmology referral form PDF (186 KB)
- View on HealthPathways
- Rural Allied Health - Community Health
-
- Rural Allied Health Referral Template PDF (95 KB) - Last updated 17/10/2018
-
- Specialist Palliative Care Rural Telehealth Service (SPaRTa)
- Referral form PDF (49 KB) - Last updated 07/2020
- Flyer PDF (847 KB)
- Wide Bay Falls Prevention
-
- WBHSS Falls Service Referral Form - last updated 13/12/22
-
- Wide Bay Hospital and Health Service
- COVID
- COVID escalation of care RTF (7 KB)
- Integrated Care (HiTH/virtual ward) service
- Integrated Care service referral form RTF (6 KB)
- Request for Procedure
-
- Private Practice Request for Procedure PDF (63kb)
-
- Specialist Outpatient Departments eReferral template
- WBHHS eReferral WORD (26 KB) - Last updated 09/07/2021
- COVID
Sunshine Coast
- Mental Health
- Stepped care mental health services
- PHN Mental Health Intake RTF (175 KB) - Last updated 20/05/2021
- Stepped care mental health services
- Nurse Navigator Service
- SCHHS Nurse Navigator Service Referral RTF (38 KB) - Last updated 16/12/2020
- Check criteria on HealthPathways
- Pulmonary Rehabilitation
- Pulmonary Rehabilitation Referral Form RTF (29 KB) - Last updated 29/01/2019
- Sunshine Coast Hospital and Health Service:
- Clinical Investigation Unit
- Nerve Conduction Studies (NCS) referral form RTF (154 KB) - Last updated 29/01/2019
- Electroencephalogram (EEG) referral form RTF (150 KB) - Last updated 29/01/2019
- COVID
- COVID escalation of care RTF (27 KB)
- Hepatitis C Treatment MDT
- SCHHS Hep C Referral RTF (26 KB) - Last updated 29/01/2019
- Open Access Colonoscopy/Gastroscopy
- SCHHS Open Access Endoscopy eReferral v5 RTF (167 KB) - Last updated 03/03/2020
- Check criteria on HealthPathways
- Specialist Outpatient Departments eReferral template
- SCHHS eReferral RTF (62 KB) - Last updated 19/10/2022
- Fax Cover Sheet RTF (32 KB) - Last updated 10/07/2017
- Check criteria on HealthPathways
- Clinical Investigation Unit
- Nurse Navigator Service
- SCHHS Nurse Navigator Service Referral RTF (22 KB) - Last updated 16/12/2020
- Check criteria on HealthPathways
- Pulmonary Rehabilitation
- Pulmonary Rehabilitation Referral Form RTF (21 KB) - Last updated 29/01/2019
- Mental Health
- Stepped care mental health services
- PHN Mental Health Intake RTF (140 KB) - Last updated 20/05/2021
- Stepped care mental health services
- Sunshine Coast Hospital and Health Service:
- Clinical Investigation Unit
- Nerve Conduction Studies (NCS) referral form RTF (39 KB) - Last updated 29/01/2019
- Electroencephalogram (EEG) referral form RTF (38 KB) - Last updated 30/01/2018
- COVID
- COVID escalation of care RTF (18 KB)
- Hepatitis C Treatment MDT
- SCHHS Hep C Referral RTF (33 KB) - Last updated 29/01/2019
- Open Access Colonoscopy/Gastroscopy
- SCHHS Open Access Endoscopy eReferral v5 RTF (83 KB) - Last updated 05/03/2020
- Check criteria on HealthPathways
- Specialist Outpatient Departments eReferral template
- SCHHS eReferral RTF (49 KB) - Last updated 21/12/2022
- Fax Cover Sheet RTF (19 KB) - Last updated 10/07/2017
- Check criteria on HealthPathways
- Clinical Investigation Unit
- SCHHS Clinical Investigation Unit
- Nerve Conduction Studies (NCS) referral form RTF (45 KB) - Last updated 29/01/2019
- Electroencephalogram (EEG) referral form RTF (45 KB) - Last updated 29/01/2019
- Stepped care mental health services
- PHN Mental Health Intake RTF (130 KB) - Last updated 23/08/2021
- Sunshine Coast Hospital and Health Service:
- Hepatitis C Treatment MDT
- SCHHS Hepatitis eReferral RTF (32 KB) - Last updated 30/01/2019
- Open Access Colonoscopy/Gastroscopy
- SCHHS Open Access Endoscopy Referral RTF (62 KB) - Last updated 29/01/2019
- Check criteria on HealthPathways
- Specialist Outpatient Departments eReferral template
- SCHHS eReferral RTF (43 KB) - Last updated 16/06/2022
- Check criteria on HealthPathways
- Hepatitis C Treatment MDT
- Mental Health
- Stepped care mental health services
- PHN Mental Health Intake ZIP (7KB) - Last updated 20/05/2021
- Stepped care mental health services
- Specialist Outpatient Departments eReferral template
- SCHHS eReferral RTF (20 KB) - Last updated 13/07/2021
- Mental Health Services in Residential Aged Care Facilities
- Lifespan Health - Mental Health Services referral form WORD (610 KB) - Last updated 25/02/2021
- Nurse Navigator Service
- SCHHS Nurse Navigator Service Referral PDF (96 KB) - Last updated 17/10/2018
- Check criteria on HealthPathways
- Persistent Pain
- Referral form
- Entry patient questionnaire PDF (336 KB) - Last updated 20/11/2017
- Pulmonary Rehabilitation
- Pulmonary Rehabilitation Referral Form PDF (189 KB) - Last updated 07/05/2019
- Mental Health Services
- Stepped care mental health services
- PHN Mental Health Intake PDF (304 KB) - Last updated 20/05/2021
- PHN Mental Health Intake WORD (89 KB) - Last updated 20/05/2021
- Stepped care mental health services
- Sunshine Coast Hospital and Health Service
- COVID
- COVID escalation of care RTF (7 KB)
- COVID
- Transition to ED Care
- Referral form - Last updated 24/11/2021
GP management plan templates
- GP Management Plan PDF (16 KB)
- GP Management Plan RTF (44 KB) - Right click, save as. Medical Director and Best Practice
- Team Care Arrangements PDF (15 KB)
- Team Care Arrangements RTF (44 KB) - Right click, save as. Medical Director and Best Practice
- Combined GP Management Plan and Team Care Arrangements PDF (44 KB)
- Combined GP Management Plan and Team Care Arrangements RTF (53 KB) - Right click, save as. Medical Director and Best Practice
- Liver
- Asthma
- Cardiac
- COPD
- Diabetes
- GORD
- GP Eating Disorders Plan [RTF]
- GP Mental Health Care Plan Template [doc]
- GP Mental Health Treatment Plan Adults
- Medical Director [RTF] - Last updated 30/11/2020
- Best Practice [RTF] - Last updated 30/11/2020
- Word [doc] - Last updated 30/11/2020
- GP Mental Health Treatment Plan Children
- Medical Director [RFT] - Last updated 30/11/2020
- Best Practice [RTF] - Last updated 30/11/2020
- Word [doc] - Last updated 30/11/2020
- GP Mental Health Treatment Plan Minimal Requirements [doc] - Last updated 31/07/2018
- GP Heart Health Assessment BP (RTF - Right click, save as)
- GP Heart Health Assessment MD (RTF - Right click, save as)
- Opioid and pain review template [RTF] Best Practice - Last updated 03/09/2020
- Opioid and pain review template [RTF] Medical Director - Last updated 03/09/2020
- Opioid and pain review template [RTF] - Last updated 03/09/2020
How to use the templates
1. Right click on the template link.
2. Select "save link/target as".
3. Open template in your software.
- View opening instructions for Best Practice templates PDF (516 KB)
- View opening instructions for Medical Director templates PDF (470 KB)
- View opening instructions for ZedMed templates PDF (258 KB)
- View opening instructions for Genie templates PDF (121 KB)
- Contact your Practice Support Officer if you require additional support.
Smart Referrals is a digital referrals capability enabling faster, streamlined management of referrals to and within Queensland public hospitals. Visit the Smart Referrals overview page for further details.