Referring clinician information

  • For clinic specific information please refer to the Pre Referral Guidelines page. 

    Download our external referral form to refer a patient to the RCH Specialist Clinics. Completed referral forms are required to be faxed to 03 9345 5034.

    Please provide as much clinical information as possible to ensure the correct clinic is allocated and include social and special circumstances, where relevant, as this may influence the urgency of the referral.

    A valid referral requires

    Patient demographic information

    • Full name 
    • Name of parent, guardian or carer
    • Address
    • Mobile phone number
    • Date of birth
    • Medicare number
    • ATSI (indigenous status)
    • CALD (interpreter requirements)

    Clinical information

    • Reason for referral- presenting problem, GP Diagnosis referral purpose
    • Physical examination results
    • Management to date
    • Investigation results
    • Relevant medical history
    • Allergies
    • Medications

     Other useful resources when referring a patiet

    If your patient requires an immediate referral. Please refer to emergency referrals.