Referral templates for Barwon Health services are available for importing into Best Practice, Medical Director or ZedMed.

Please refer to the New Templates 2024 list for the most up to date referral forms. Templates that are still undergoing review for updating may be found under the existing template section.

If you need to contact us regarding the templates, please contact the GP Liaison Unit on (03) 4215 8845 or [email protected]

For relevant referral and service criteria, please visit https://westvic.communityhealthpathways.org/

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

Template Version date Click on the appropriate software Referral template for

Advance Care Planning

 April 2024 BP  MD ZedMed Advance Care Planning
Andrew Love Cancer Centre Nov 2024 BP MD ZedMed Cancer Services – Medical Oncology, Haematology, Radiation Oncology
Audiology April 2024 BP  MD ZedMed Audiology services
Barwon Health North
Child and Family Services		 April 2024 BP  MD ZedMed BHN Child & Family Services
Cardiology Consultation Nov 2024 BP MD ZedMed Geelong Cardiology Practice
Cardiology Diagnostic Services Nov 2024 BP MD ZedMed Geelong Cardiology Practice Diagnostic testing request
Community Health & Rehab April 2024 BP  MD ZedMed
  • Community Rehabilitation Centre
  • Community Geriatric Clinic
  • Concussion Clinic
  • Continence Clinic
  • Falls & Balance Clinic
  • Motor Neurone Disease Clinic
  • Spasticity Management Clinic
  • Prosthetics & Orthotics service
  • McKellar Kids Rehab (VPRS/YATS)
  • Community Health & Primary Care services
Community Nursing April 2024 BP  MD ZedMed Community Nursing services
Connected Care April 2024 BP  MD ZedMed
  • Complex Care community services
  • Hospital Admission Risk Program
Diabetes Referral Centre (DRC) May 2024 BP  MD Zedmed
Early Parenting Centre (Barwon EPC) August 2024 BP MD Zedmed For families of children aged 0 – 4 years
Gynae Choices (TOP) May 2024 BP  MD  Zedmed
Medical Outpatients May 2024 BP MD ZedMed
  • Barwon Reproductive and Sexual Health Clinic (BRASH)
  •  Chronic Liver Disease + Hep C clinics
  • Dermatology clinic
  • Endocrinology public clinic
  • Gastroenterology clinic
  • General Medicine clinic
  • Gen Med Early Access Clinic
  • Inflammatory Bowel Disease clinic
  • Infectious Diseases (+ Refugee service)
  • Liver Mass clinic
  • Respiratory clinics
  • Cardiology public clinics
  • Neuroscience public clinics
  • Renal services public clinic
  • Medical Day Stay unit ( Iron Infusion)
  • Hospital In the Home
Memory Clinic April 2024 BP  MD ZedMed Cognitive Dementia and Memory Service (McKellar)
Eating Disorders April 2024 BP  MD ZedMed Eating Disorder Service
Pain Clinic May 2024 BP  MD  Zedmed Pain Clinic
Palliative Care May 2024 BP  MD  Zedmed Palliative Care
Mental Health, Drugs & Alcohol April 2024 BP  MD ZedMed Mental Health, Drugs & Alcohol triage & access
Orthopaedic Clinics September 2024 BP MD ZedMed
  • Ortho – General
  • Ortho – Fracture Clinic
Paediatric BRANCHS Clinic November 2024 BP MD ZedMed
Paediatric Dermatology Clinic November 2024 BP MD ZedMed
Paediatric Ortho Clinic September 2024 BP MD ZedMed Developmental Hip Dyslapsia (DDH) and Clubfoot
Smoking Cessation April 2024 BP  MD ZedMed Smoking Cessation service/Be Smokefree Clinic
Surgical Outpatients September 2024 BP MD ZedMed
  • ENT
  • General Surgery (incl. Breast)
  • Gynaecology (not Colposcopy)
  • Neurosurgery
  • Oral Maxillofacial
  • Ophthalmology
  • Paediatric General Surgery
  • Pelvic Floor Assessment Clinic
  • Persistent Pelvic Pain Clinic
  • Plastic Surgery
  • Urology
  • Vascular Surgery

Referral template for Click on the appropriate software

Version Date
Colonoscopy BP   MD   Zedmed Jul 2019
Colposcopy BP   MD   Zedmed

Feb 2022
Emergency Department (ED) BP   MD   Zedmed

Jul 2019
Gastroscopy BP   MD   Zedmed

Jul 2019
Pregnancy Care

  • Pregnancy Care clinics
  • Obstetric specialty clinics
 BP     MD    ZedMed Mar 2023
Preg Loss on USS (asymptomatic) EPAS BP   MD   Zedmed

Nov 2021

Page last updated: November 25, 2024