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PDF Referral Forms

Health professionals who do not have a Medicare provider number can now send an eReferral by completing the appropriate fillable PDF and emailing directly to the relevant Community-based service.

If the appropriate fillable PDF form is not yet available, please refer as per the current process. If you need assistance, please call the Access Team on (03) 8572 5631.

eReferrals are the most secure, safe and reliable way to send a referral to Monash Health.

Fillable PDF forms

The following referral forms are available. If the appropriate fillable PDF form is not yet available, please refer as per the current process. If you need assistance, please call the Access Team on (03) 8572 5631.

External Adult Community-based Service Referral Form

PDF document

Adult Referral form for Monash Health Employees

PDF document

Quick Reference Guide: Adult Community Referral form for Monash Health Employees

PDF document

Centre for Developmental Disability Health (CDDH) Referral Form

PDF document

Child Health Referral Form

PDF document

Healthy Mothers Healthy Babies Referral Form

PDF document

Multi Disciplinary Nursing ISBAR (for INTERNAL Monash Health Referrals only)

PDF document

Multi Disciplinary Nursing EXTERNAL Referral Form

PDF document

Post Acute Care (PAC) Referral Form

PDF document

Refugee Health Referral Form

PDF document

Youth Services Referral Form

PDF document

eReferral Support

If you require help with a referral to Monash Health Community-based services, please call the number listed on the Referrals for Community-based services page here.

For enquiries regarding submitted referrals, or support using HealthLink eReferrals.

Hours

Monday to Friday, 8:30am to 4:30pm, excluding public holidays

Phone

1300 342 273 (Dial 6 for support using HealthLink)

Email

screferralmanagement@monashhealth.org