Templates and forms
Find referral templates for practice software below.
Ensure you follow instructions on how to open the templates.
Queensland Health
- Secure Web Transfer and eHealth:
- STS AddressBook Individual Update Form: 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: 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.
- Brisbane hospital referrals
- Paediatric Statewide Referral Criteria
- 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.
Central Queensland
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC Referral for Nhulundu (Gladstone and Banana) [Word] – Last updated 25/03/2020
- ITC referral (Bidgerdii) [Word] – Last updated 05/12/2019
- ITC referral Yoonthalla Services (Woorabinda) [RTF] – Last updated 19/02/2020
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- Colonoscopy/Gastroenterology
- No additional templates required.
- Hospital and Health Service Specialist Outpatient Departments eReferral template
- Coming soon.
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Persistent Pain
- No additional templates required.
- Stepped care mental health services
- PHN Mental Health Intake [RTF] – Last updated 01/04/2020
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC Referral for Nhulundu (Gladstone and Banana) [PDF] – Last updated 15/01/2019
- CCSS Referral (Bidgerdii) [Word] – Last updated 19/02/2020
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- Colonoscopy/Gastroenterology
- CQHHS Endoscopy referral form [RTF] – Last updated 01/04/2020
- Hospital and Health Service Specialist Outpatient Departments eReferral template
- SOPD referral form CQ wide [RTF] – Last updated 01/04/2020
- SOPD referral form Emerald [RTF] – Last updated 01/04/2020
- SOPD referral form Gladstone [RTF] – Last updated 01/04/2020
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Persistent Pain
- No additional templates required
- Public Allied Health Services
- CQHHS Sub Acute Care and Chronic Rehabilitation referral form [RTF] – Last updated 01/02/2020
- CQHHS Podiatry referral form [RTF] – Last updated 01/02/2020
- Stepped care mental health services
- PHN Mental Health Intake [RTF] – Last updated 07/04/2020
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Persistent Pain
- No additional templates required
- Stepped care mental health services
- PHN Mental Health Intake [RTF] – Last updated 22/04/2020
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Persistent Pain
- No additional templates required
- Stepped care mental health services
- PHN Mental Health Intake – Last updated 23/04/2020
Wide Bay
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC Referral for Bundaberg [PDF] – Last updated 09/07/2019
- ITC Referral for Bundaberg [RTF] – Last updated 09/07/2019
- ITC Referral for Fraser Coast [RTF] – Last updated 31/07/2018
- ITC Referral for North Burnett [RTF] – Last updated 31/07/2018
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- Colonoscopy/Gastroenterology
- Colonoscopy/Endoscopy Referral Form [RTF] – Last updated 17/10/2018
- Colonoscopy/Endoscopy Referral Form [PDF] – V2 2019
- View on HealthPathways
- Hepatitis C Treatment MDT
- SCHHS Hep C Referral [RTF] – Last updated 10/07/2017
- Hospital and Health Service Specialist Outpatient Departments eReferral template
- WBHHS eReferral [RTF] – Last updated 16/04/2019
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Nurse Navigator Service
- WBHHS Nurse Navigator Service Referral [PDF] – Last updated 17/10/2018
- View on HealthPathways
- Persistent Pain
- Referral form [PDF] – Last updated 09/2014
- Entry patient questionnaire [PDF] – Last updated 20/11/2017
- Rural Chronic Pain Self-Management Group [PDF] – Last updated 18/07/2018
- View on HealthPathways
- Pulmonary Rehabilitation
- View on HealthPathways
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [RTF] – Last updated 12/10/2018
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [DOCX] – Last updated 12/10/2018
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [PDF] – Last updated 12/10/2018
- Ophthalmology
- Ophthalmology referral form [PDF] – V4 2019
- View on HealthPathways
- Rural Allied Health – Community Health
- Rural Allied Health Referral Template [PDF] – Last updated 17/10/2018
- Rural Primary Health Services
- RPHS Referral Template [RTF] – Last updated 8/11/2018
- Stepped care mental health services
- PHN Mental Health Intake [RTF] – Last updated 01/04/2020
- Vaccination History or Catchup
- WBHSS Referral Template [RTF] – Last updated 17/10/2018
- Aboriginal and Torres Strait Islander Chronic Disease Management (CCSS and ITC)
- ITC Referral for Bundaberg [PDF] – Last updated 04/07/2019
- ITC Referral for Bundaberg [RTF] – Last updated 04/07/2019
- ITC Referral for Fraser Coast [RTF] – Last updated 11/07/2018
- ITC Referral for North Burnett [RTF] – Last updated 31/07/2018
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- Colonoscopy/Gastroenterology
- Colonoscopy/Endoscopy Referral Form [RTF] – Last updated 17/10/2018
- Colonoscopy/Endoscopy Referral Form [PDF] – V2 2019
- View on HealthPathways
- Hepatitis C Treatment MDT
- SCHHS Hep C Referral [RTF] – Last updated 29 January 2019
- Hospital and Health Service Specialist Outpatient Departments eReferral template
- WBHHS eReferral [RTF] – Last updated 16/04/2019
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Nurse Navigator Service
- WBHHS Nurse Navigator Service Referral [PDF] – Last updated 17/10/2018
- View on HealthPathways
- Ophthalmology
- Ophthalmology referral form [PDF] – V4 2019
- View on HealthPathways
- Persistent Pain
- Referral form [PDF] – Last updated 09/2014
- Entry patient questionnaire [PDF] – Last updated 20/11/2017
- Rural Chronic Pain Self-Management Group [PDF] – Last updated 18/07/2018
- View on HealthPathways
- Pulmonary Rehabilitation
- View on HealthPathways
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [RTF] – Last updated 12/10/2018
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [DOCX] – Last updated 12/10/2018
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [PDF] – Last updated 12/10/2018
- Rural Allied Health – Community Health
- Rural Allied Health Referral Template [PDF] – Last updated 17/10/2018
- Rural Primary Health Services
- RPHS Referral Template [RTF] – Last updated 8/11/2018
- Stepped care mental health services
- PHN Mental Health Intake [RTF] – Last updated 07/04/2020
- Vaccination History or Catchup
- WBHSS Referral Template [RTF] – Last updated 17/10/2018
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- Colonoscopy/Gastroenterology
- Colonoscopy/Endoscopy Referral Form [PDF] – V2 2019
- View on HealthPathways
- Hepatitis C Treatment MDT
- SCHHS Hepatitis eReferral [RTF] – Last updated 30 January 2019
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Nurse Navigator Service
- WBHHS Nurse Navigator Service Referral [PDF] – Last updated 17/10/2018
- View on HealthPathways
- Ophthalmology
- Ophthalmology referral form [PDF] – V4 2019
- View on HealthPathways
- Persistent Pain
- Referral form [PDF] – Last updated 09/2014
- Entry patient questionnaire [PDF] – Last updated 20/11/2017
- Rural Chronic Pain Self-Management Group [PDF] – Last updated 18/07/2018
- View on HealthPathways
- Pulmonary Rehabilitation
- View on HealthPathways
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [DOCX] – Last updated 12/10/2018
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [PDF] – Last updated 12/10/2018
- Rural Allied Health – Community Health
- Rural Allied Health Referral Template [PDF] – Last updated 17/10/2018
- Therapeutic Referral
- PHN Mental Health Intake – [RTF] – Last updated 22/04/2020
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- Colonoscopy/Gastroenterology
- Colonoscopy/Endoscopy Referral Form [PDF] – V2 2019
- View on HealthPathways
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Nurse Navigator Service
- WBHHS Nurse Navigator Service Referral [PDF] – Last updated 17/10/2018
- View on HealthPathways
- Ophthalmology
- Ophthalmology referral form [PDF] – V4 2019
- View on HealthPathways
- Persistent Pain
- Referral form [PDF] – Last updated 09/2014
- Entry patient questionnaire [PDF] – Last updated 20/11/2017
- Rural Chronic Pain Self-Management Group [PDF] – Last updated 18/07/2018
- View on HealthPathways
- Pulmonary Rehabilitation
- View on HealthPathways
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [DOCX] – Last updated 12/10/2018
- Pulmonary Rehabilitation Referral Form – Hervey Bay Physio [PDF] – Last updated 12/10/2018
- Rural Allied Health – Community Health
- Rural Allied Health Referral Template [PDF] – Last updated 17/10/2018
- Stepped care mental health services
- PHN Mental Health Intake – Last updated 20/04/2020
Sunshine Coast
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Pulmonary Rehabilitation
- Pulmonary Rehabilitation Referral Form [RTF] – Last updated 29/01/2019
- Pulmonary Rehabilitation Referral Form [PDF] – Last updated 07/05/2019
- Stepped care mental health services
- PHN Mental Health Intake [RTF] – Last updated 22/04/2020
- Sunshine Coast Eating Disorder Trial
- Doctor referral form [RTF] – Last updated 04/12/2019
- Sunshine Coast Hospital and Health Service:
- Clinical Investigation Unit
- Nerve Conduction Studies (NCS) referral form [RTF] – Last updated 29/01/2019
- Electroencephalogram (EEG) referral form [RTF] – Last updated 29/01/2019
- Hepatitis C Treatment MDT
- SCHHS Hep C Referral [RTF] – Last updated 29/01/2019
- Nurse Navigator Service
- SCHHS Nurse Navigator Service Referral [PDF] – Last updated 17/10/2018
- Check criteria on HealthPathways
- Open Access Colonoscopy/Gastroscopy
- SCHHS Open Access Endoscopy eReferral v5 [RTF] – Last updated 03/03/2020
- Check criteria on HealthPathways
- Persistent Pain
- Referral form [PDF] – Last updated 09/2014
- Entry patient questionnaire [PDF] – Last updated 20/11/2017
- Specialist Outpatient Departments eReferral template
- SCHHS eReferral[RTF] – Last updated 29/01/2019
- Gympie eReferral[RTF] – Last updated 07/04/2017
- Fax Cover Sheet [RTF] – Last updated 10/07/2017
- Check criteria on HealthPathways
- Clinical Investigation Unit
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Pulmonary Rehabilitation
- Pulmonary Rehabilitation Referral Form [RTF] – Last updated 29/01/2019
- Pulmonary Rehabilitation Referral Form [PDF] – Last updated 27/05/2019
- Stepped care mental health services
- PHN Mental Health Intake [RTF] – Last updated 22/04/2020
- Sunshine Coast Eating Disorder Trial
- Doctor referral form [RTF] – Last updated 22/05/2019
- Sunshine Coast Hospital and Health Service:
- Clinical Investigation Unit
- Nerve Conduction Studies (NCS) referral form [RTF] – Last updated 29/01/2019
- Electroencephalogram (EEG) referral form [RTF] – Last updated 30/01/2018
- Hepatitis C Treatment MDT
- SCHHS Hep C Referral [RTF] – Last updated 29/01/2019
- Nurse Navigator Service
- SCHHS Nurse Navigator Service Referral [PDF] – Last updated 17/10/2018
- View on HealthPathways
- Open Access Colonoscopy/Gastroscopy
- SCHHS Open Access Endoscopy eReferral v5 [RTF] – Last updated 05/03/2020
- Check criteria on HealthPathways
- Persistent Pain
- Referral form [PDF] – Last updated 09/2014
- Entry patient questionnaire [PDF] – Last updated 20/11/2017
- Specialist Outpatient Departments eReferral template
- SCHHS eReferral [RTF] – Last updated 29/01/2019
- Gympie eReferral [RTF] – Last updated 7/04/2017
- Fax Cover Sheet [RTF] – Last updated 10/07/2017
- Check criteria on HealthPathways
- Clinical Investigation Unit
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Pulmonary Rehabilitation
- Pulmonary Rehabilitation Referral Form [PDF] – Last updated 7/05/2019
- SCHHS Clinical Investigation Unit
- Nerve Conduction Studies (NCS) referral form [RTF] – Last updated 29/01/2019
- Electroencephalogram (EEG) referral form [RTF] – Last updated 29/01/2019
- Stepped care mental health services
- PHN Mental Health Intake– [RTF] – Last updated 22/04/2020
- Sunshine Coast Hospital and Health Service:
- Hepatitis C Treatment MDT
- SCHHS Hepatitis eReferral [RTF] – Last updated 30/01/2019
- Nurse Navigator Service
- SCHHS Nurse Navigator Service Referral [PDF] – Last updated 17/10/2018
- Check criteria on HealthPathways
- Open Access Colonoscopy/Gastroscopy
- SCHHS Open Access Endoscopy Referral [RTF] – Last updated 29/01/2019
- Check criteria on HealthPathways
- Persistent Pain
- Referral form [PDF] – Last updated 09/2014
- Entry patient questionnaire [PDF] – Last updated 20/11/2017
- Specialist Outpatient Departments eReferral template
- SCHHS eReferral [RTF] – Last updated 29/01/2019
- Check criteria on HealthPathways
- Hepatitis C Treatment MDT
- Children’s Health Queensland
- Access templates – Last updated 12/05/2020
- My Health For Life
- Referral form [RTF] – V2.0
- GP Referral Form [PDF] – Last updated 17/10/2018
- PEN CS Recipes
- Pulmonary Rehabilitation
- Pulmonary Rehabilitation Referral Form [PDF] – Last updated 07/05/2019
- Stepped care mental health services
- PHN Mental Health Intake [RTF] – Last updated 23/04/2020
- Sunshine Coast Hospital and Health Service:
- Nurse Navigator Service
- SCHHS Nurse Navigator Service Referral [PDF] – Last updated 17/10/2018
- Check criteria on HealthPathways
- Persistent Pain
- Referral form [PDF] – Last updated 09/2014
- Entry patient questionnaire [PDF] – Last updated 20/11/2017
- Nurse Navigator Service
GP management plan templates
- GP Management Plan [PDF]
- GP Management Plan [RTF – Right click, save as. Medical Director and Best Practice]
- Team Care Arrangements [PDF]
- Team Care Arrangements [RTF – Right click, save as. Medical Director and Best Practice]
- Combined GP Management Plan and Team Care Arrangements [PDF]
- Combined GP Management Plan and Team Care Arrangements [RTF – Right click, save as. Medical Director and Best Practice]
- GP Mental Health Care Plan Template [doc]
- GP Mental Health Treatment Plan Template – Minimal Requirements [doc] – Last updated 31/07/2018
- GP Eating Disorders Plan [RTF]
- GP Heart Health Assessment BP (RTF – Right click, save as)
- GP Heart Health Assessment MD (RTF – Right click, save as)
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
- View opening instructions for Medical Director templates
- View opening instructions for ZedMed templates
- View opening instructions for Genie templates
- 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.
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