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The Prince Charles Hospital - Haematology

Referral required from general practitioner. General Practitioners refer through Central Patient Intake Service

Royal Brisbane and Women's Hospital - Haematology

Please forward all investigation results which led to the referral.
Referral must include:
•	Patient demographics including full name, date of birth, contact details, postal address or contact address (if not the same as usual residence)
•	Date of referral
•	Referring practitioner's full name, address and contact details
•	Referring practitioner's provider number and signature
•	Detailed reason for referral (including the problem to be assessed, degree of loss of function, pain experienced, ect)
•	Relevant information about patient's condition such as previous medical/ surgical treatment (include systemic and topical medications prescribed for the condition) and any associated medical conditions which may affect the condition or its treatment (e.g. Diabetes)
•	Current medications and doses, prescribed and over the counter (Note any recent changes in drug therapy)
•	Allergies (drug/ topical preparation)
•	Aboriginal, Torres Strait Islander status 
Desirable Referral Information:
•	Relevant psychological and social issues impacted by condition 
•	Smoking and alcohol history
•	South Sea Islander status 
•	Medicare Number 
•	Interpreter requirements 
•	Patient status (DVA, Work cover, Motor Vehicle Insurance, Medicare Ineligible) 
Please forward all investigation results which led to the referral

Royal Brisbane and Women's Hospital - Cancer Care Services

Albanycare 7 Day Medical Centre

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Queensland Children's Hospital (Lady Cilento Children's Hospital)

Queensland Children's Hospital

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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. Any pathology results that may indicate duration/ progression of blood abnormality. Previous radiation treatment

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Haematology in Chermside

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Haematology in Chermside

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