GP Referral Templates

The Barwon Health Referral Templates have been updated to reflect the new Barwon Health phone and fax numbers.

If you need to contact us regarding the forms, please call the GP Liaison Unit on (03) 4215 8845 or email gpfeedback@barwonhealth.org.au.

IMPORTANT: please read the instruction documents below to ensure you successfully import the template you require.

Referral template for

Click on the appropriate software

Version Date

Aged Care Assessment Service (ACAS)

BP   MD   Zedmed

Nov 2012

Advance Care Planning

BP   MD   Zedmed   PDF

Nov 2012

Andrew Love Cancer Centre (ALCC)

BP MD  Zedmed

Oct 2015

Colonoscopy

BP MD  Zedmed

Oct 2015

Colposcopy

BP   MD   Zedmed

July 2012

Community Health & Rehabilitation (CH&R)

BP   MD   Zedmed

Nov 2012

Community Nursing BP MD  Zedmed Oct 2015

DDH Club Foot

BP MD  Zedmed

Oct 2015

Diabetes Referral Centre (DRC) 

BP MD  Zedmed

Oct 2015

Eating Disorders

BP   MD   Zedmed

Dec 2014

Emergency Department (ED) 

BP   MD   Zedmed

Nov 2012

Gynae Choices (TOP)

Hepatitis C Remote Consultation for Initiation of Treatment

BP MD  Zedmed

BP MD Zedmed PDF

Oct 2015

June 2016

Hospital Admission Risk Program (HARP)

BP   MD   Zedmed

Nov 2012

Hospital in the Home

BP   MD   Zedmed

Sep 2013

Medical Outpatients

BP MD  Zedmed

Apr 2016

Memory Clinic

BP   MD   Zedmed

Nov 2012

Mental Health Drug & Alcohol Services

BP   MD   Zedmed

Dec 2014

Ortho OPD

BP MD  Zedmed

Oct 2015

Pain Clinic

BP MD  Zedmed  PDF

Oct 2015

Palliative Care

BP   MD   Zedmed

Nov 2012

Pregnancy Care Clinic (PCC)

BP   MD   Zedmed   PDF

Dec 2014

Preg Loss on USS (asymptomatic) EPAS

BP   MD   Zedmed   PDF

Dec 2014

Smoking Cessation / Be Smokefree

BP   MD   Zedmed   PDF   

Aug 2015

Surgical OPD

BP MD  Zedmed         

Oct 2015

Primary Mental Health Partners & Headspace

BP   MD   Zedmed

Dec 2014

Traditional Owners

We, Barwon Health, acknowledge the Traditional Owners of the land, the Wadawurrung people of the Kulin Nation. We pay our respects to the Elders both past and present.