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Central Queensland
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Sunshine Coast
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Wide Bay
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| Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC) |
ITC Referral for Nhulundu (Gladstone and Banana)
ITC referral [RTF] (Bidgerdii)
ITC referral (Woorabinda)
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View on HealthPathways
ITC Referral for Bundaberg [PDF]
ITC Referral for Bundaberg [RTF]
ITC Referral for Fraser Coast [RTF]
ITC Referral for North Burnett [RTF] – Last updated 31/07/2018
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| Hospital and Health Service Specialist Outpatient Departments eReferral template |
Coming soon. |
Information Sheet
SCHHS eReferral
Gympie eReferral
Fax Cover Sheet
Fax Sheet info
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View on HealthPathways |
| Gastroenterology procedural referral |
No additional templates required |
SCHHS Open Access Endoscopy eReferral v2
View on HealthPathways |
View on HealthPathways |
| Persistent Pain |
No additional templates required |
Referral form [PDF]
Entry patient questionnaire [PDF]
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Referral form [PDF]
Entry patient questionnaire [PDF]
Rural Chronic Pain Self-Management Group [PDF] – Last updated 18/07/2018
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| Children’s Health Queensland |
Access templates |
Access templates |
Access templates |
| Lungmax |
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Pulmonary Rehabilitation Referral Form [RTF]
Pulmonary Rehabilitation Referral Form [PDF]
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Referral Form |
| Hepatitis C Treatment MDT |
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SCHHS Hep C Referral |
SCHHS Hep C Referral |
| My Health For Life |
Referral form [RTF]
PEN CS Recipes
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Referral form [RTF]
PEN CS Recipes
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Referral form [RTF]
PEN CS Recipes
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| SCHHS Clinical Investigation Unit |
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Nerve Conduction Studies (NCS) referral form [RTF]
Electroencephalogram (EEG) referral form [RTF]
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| Nurse Navigator Service |
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SCHHS Nurse Navigator Service Referral [PDF]
NNS Patient Enrollment Criteria [PDF]
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Artius Referral Template |
| Artius Referrals |
Artius Referral Template [RTF] |
Artius Referral Template [RTF] |
Artius Referral Template [RTF] |
| Therapeutic Referral |
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QuIHN Therapeutic Referral [DOCX] |
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| Partners in Recovery |
Partners in Recovery CQ [RTF] |
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