Referral forms and templates for SALHN
Please see the referral forms below. Some referral templates have been adapted for GP clinical software systems and can be imported into clinical software. This will save time for referring clinicians.
For more SALHN outpatient clinic information, please see our Outpatient Specialist Clinics section (includes quick links to SALHN Outpatient Clinic list, triage and referral guidelines, state-wide waiting time report).
Work is progressing in relation to the state-wide electronic referral program. Further updates will be made available through our Southern GP Matters Newsletter as relevant. If you would like to sign up for the newsletter, provide feedback or be include in this project, please contact the GP Integration Unit.
Importing templates for specific specialties
Instructions on how to import templates into GP clinical software systems are provided below:
- Best Practice template fact sheet (PDF 54KB)
- Medical Director template fact sheet (PDF 55KB)
- Zedmed template fact sheet (PDF 57KB)
Statewide referral forms
- Short version - Statewide Referral Form (PDF 64KB)
- Long version - Statewide Referral Form (PDF 177KB)
- Best Practice Template Statewide Referral Form
- Medical Director template - Statewide Referral Form (RTF 126KB)
- Zedmed template - Statewide Referral Form (RTF 87KB)
Medical clinics - SALHN
- Neurology Outpatient Clinic Request form (DOC 128KB)
- Neurophysiology Outpatient Request form (DOC 136KB)
- Palliative Care Referral Form (PDF 581KB)
- Rehabilitation and Aged Care:
- Respiratory Out of Hospital, including:
- Airway clearance, Respiratory Nurse service, Speech Pathology:
- Pulmonary Rehabilitation:
Surgical clinics - SALHN
- Weight management - Bariatric Surgery:
Mental Health and Drug and Alcohol
- Booked Assessment Service (one-off psychiatric assessment):
- Centre for Anxiety and Related Disorders (CARD) (PDF 365KB)
- Community Mental Health Team (CMHT - Routine Referrals):
- Drug and Alcohol Services SA (DASSA):
- Mental Health Triage – Urgent referrals: please call 13 14 65 (no referral form)
Paediatric clinics - SALHN
- Children’s Assessment Team (CAT) (DOC 3.7MB)
- Early Childhood and Family:
- For Women’s and Children’s Hospital - view Paediatric referral forms
Women’s health clinics - SALHN
- For Women’s and Children’s Hospital – view Women’s Health referral forms
Allied Health clinics - SALHN
- Diabetes Out of Hospital, including Diabetes education:
- High Risk Foot:
- Lymphoedema Referral Form (DOC 897KB)