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 (to be completed by a parent or carer)

• Referrals to our Paediatrician Clinic requires a GP referral, please see this page for more information.
• To make an enquiry or book an appointment, please complete this Referral Form: For Children aged 0 to 6 year
• Prior to your appointment, please complete this ‘Getting to Know Your Child‘ form

Referral forms for young people and adults up to 64 years

• Counselling: Referral form
• NDIS: Referral form
• Trans and gender diverse health: Service access form

Referral forms for adults 65 years and over

• Counselling: Referral form
• Home Care Package: Referral form