Referrals to specialist outpatient services within Princess Alexandra Hospital must be in writing, and as a minimum contain the following:
• Patient demographics including Medicare number and Interpreter requirements
• Patient's mobile phone contact number and an alternate postal or contact address (if not the same as usual residence)
• Reason for referral (including the problem to be assessed, degree of loss of function, pain experienced)
• Results of relevant investigations (pathology, radiology, histology)
• Current medications and doses, prescribed and over the counter (note any recent changes in drug therapy)
• Allergies (drug/topical preparation)
• Relevant information about the patient's condition such as previous medical/surgical treatment (include systemic and topical medications prescribed for the condition) and details of any associated medical conditions which may affect the condition or its treatment (e.g., diabetes)
• Relevant psychological and social issues impacted by condition
• Smoking and alcohol history.
• hormone levels
• relevant investigations - any relevant imaging studies
• hormone levels relevant investigations - any relevant imaging studies
For a pituitary problem:
• morning prolactin, LH, FSH, oestradiol (testosterone if male), TSH, T4, cortisol, ACTH, growth hormone, IGF1, ELFT, FBE
For thyrotoxicosis:
• TSH, T4, T3, ESR, TSH receptor antibodies, (Primary hypothyroidism should be able to be managed by the GP and not require specialist referral).
For calcium disorder:
• ELFT, ionised calcium, PTH, Vitamin D and 1,25(OH)2 Vitamin D, 24 hour urine calcium. If primary
hyperparathyroidism include bone mineral density and US kidneys or AXR KUB
For osteoporosis:
• FBE, ELFT, ESR, Vitamin D, PTH, ionised calcium, TSH, serum EPP, anti-transglutaminase antibodies, bone mineral density and vertebral x-rays or x-rays of fractures if relevant
For adrenal insufficiency:
• short synacthen test, morning cortisol and ACTH, renin and aldosterone
For Cushing's syndrome:
• 24 hour urine free cortisol, 1mg dexamethasone suppression test, morning cortisol, ACTH
For hypogonadism:
• morning LH, FSH, oestradiol and progesterone (testosterone if male), prolactin