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Refer a patient

Thank you for considering a referral to my clinic. I provide consultant-led assessment for undifferentiated symptoms, complex presentations, and general medical concerns, with rapid access to appropriate investigations when needed.

Referrals are welcome from GPs, specialists and allied health professionals. Every patient receives a clear clinical report and practical next steps to support ongoing care.

This is a private, appointment-only service and not an emergency pathway.

Referrer's details

Preferred contact method
Phone
Email

Patient's details

Date of Birth
Day
Month
Year
Multi-line address
Is the patient aware of this referral?
Yes
No
Interpreter required?
Yes
No
Reason for Referral. Please select the most appropriate clinic (choose more than one if relevant):
General Medicine Clinic
Rapid Access Clinic (urgent non-emergency assessment)
Breath & Lung Clinic (including spirometry)
Heart & Blood Pressure Clinic (including ABPM & Holter/patch ECG monitoring)
Weight & Metabolic Health Clinic
Cancer Concern and Exclusion Clinic
Recovery & Post-Viral Clinic

Please include onset, pattern, red flags you are concerned about, and what you hope this assessment

Please include relevant history / findings, current medications, allergies.

Investigations Already Done (if any)
Urgency
Urgent (24 - 72 hours)
Soon (1 - 2 weeks)
Routine
Optional Requests
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Date
Day
Month
Year
Medical Testing Supplies
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