Make a Referral
These online referral forms help us understand your needs, so that we can provide you with appropriate, high quality care.
You may be asked to complete a form before attending your first appointment.
Please contact us on (03) 8470 1111 for all other referral forms.
Referral forms for children
These forms should be completed by a parent or carer.
- Booking with our Paediatrician Clinic requires a GP referral, please see this page for more information.
- To make an enquiry or book an appointment with our Allied Health team, please complete this Referral Form: For Children aged 0 to 6 year.
Once your child has an appointment
These forms should be completed by a parent or carer.
- Prior to your child’s Allied Health appointment, please complete the Getting to Know Your Child form.
Referral forms for young people and adults up to 64 years
Referral forms for adults 65 years and over
- Counselling: Referral form (no new referrals accepted until after 1 March 2025)
- Home Care Package: Referral form