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Women’s and Children’s Hospital
Acknowledgement
The Women's and Children's Hospital is located on the traditional lands for the Kaurna people, and we respect their spiritual relationship with their Country. We also acknowledge that the Kaurna people are the custodians of the Adelaide region, and that their cultural and heritage beliefs are still as important to the living Kaurna people today.

Aboriginal and Torres Strait Islander people should be aware that this website may contain images, voices and names of people who have passed away.

Referral Forms for WCH Outpatient Clinics

The WCHN recommends that referring clinicians use the supplied referral templates and forms to assist with appropriate and timely triage of patient’s referrals.

All referral forms are available in Microsoft Word or PDF document format.

Some referral templates have been adapted for clinical software systems and can be downloaded into clinical software. This will save time for referring clinicians.

WCH Referral Forms

WCH Clinic-specific Forms

Templates for GP/Referring Clinician Software

Downloadable Templates for Best Practice Software

These referral templates are designed to be downloaded into Best Practice medical software systems. If you do not have Best Practice, use the Word document version above.

Downloadable Templates for Medical Director Software

These referral templates are designed to be downloaded into Medical Director medical software systems. If you do not have Medical Director, use the Word document version above.

Downloadable Templates for ZedMed Software

These referral templates are designed to be downloaded into Zedmed medical software systems. If you do not have Zedmed, use the Word document version above.

Web-based Referral Form

For referring practitioners who do not have a practice software package

Please note:

  • The web-based form has been decommissioned – it will be replaced by a new e-Referral system in the coming months. In the meantime, please use the Word version of the paediatric outpatient referral form:

Further Information

How to use the referral forms and templates

All versions of the referral form should be signed by the referring medical practitioner prior to faxing it to the WCH Administration Hub at 08 8161 6246. If you are sending electronically, add an electronic GP signature to your template.

Referrals will only be accepted on one of the official forms, as outlined above. We cannot accept referral forms that are incomplete or that have not been signed by the referring medical practitioner.

Instructions for downloading templates to GP Software

Best Practice Instructions

  1. Download the template from the link and click “Save As”.
  2. Save the template where it may be easily accessed for import to Best Practice.
  3. Import into Best Practice.

Medical Director Instructions

  1. Download the template from the link and click “Save As”.
  2. Save the template where it may be easily accessed for import to Medical Director.
  3. Import into Medical Director.

Referrals to Outpatient Clinics

The Women’s and Children’s Hospital has a range of specialist outpatient clinics. Referral guidelines have been specifically developed for Medical Practitioners who are referring patients for outpatient care.
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