Some of our services and clinics have a preferred form or process for referring clinicians to use when referring a patient. You can find specific referrals information on each of our service pages.

We have provided copies of the preferred referral forms used by our services and clinics for you to download and fill in. Where a specific form is not listed, you may use either a template from your own system or our standard referral form.

Please ensure your referral is signed (including electronically).

Standard referral form

Our standard referral form is used by the majority of our services and clinics:

The RMH referral form (327KB - pdf document)
In the interests of providing timely care, please note that the practitioner named on your patient’s referral may not be the same practitioner who provides care at the RMH.

Statewide referral criteria

Statewide referral criteria (SRC) are clinical decision-support tools that give health professionals the referral criteria they need to refer their patients to public specialist outpatient services across Victoria.

The criteria allows people who need to see a health professional in a Victorian public specialist outpatient service to be referred and prioritised in a safe and timely way.

See the 13 specialities for criteria.

HealthPathways

For referral criteria for other specialties, visit HealthPathways Melbourne. HealthPathways offers clinicians locally agreed information to make the right decisions together with patients, at the point of care.

Before faxing your referral

Check the information on the service or clinic page for additional referral criteria.

Specialty referral forms

Back Assessment Clinic referral forms
Familial Cancer Centre referral forms
Medical Imaging request forms
Mental Health Services referral forms
Ophthalmology referral form
Spine Virtual Fracture Clinic referral form
Urology referral form
Statewide Referral Criteria for specialist clinics
The Department of Health developed statewide referral criteria to assist GPs and clinicians referring patients to specialist clinics and improve the quality and appropriateness of referrals to specialist clinics in public hospitals.
Health.vic: Minimum information for referrals to non-admitted specialist services
Required information when referring requests to public non-admitted specialist services.
HealthPathways Melbourne
HealthPathways offers clinicians locally agreed information to make the right decisions together with patients, at the point of care.
The RMH referral form (327KB - pdf document)
In the interests of providing timely care, please note that the practitioner named on your patient’s referral may not be the same practitioner who provides care at the RMH.
Contact us
GP referrals
Fax
(03) 9342 4234
Referrals for Specialist Clinics
GP Liaison
Mon-Thu 9am-5pm
Phone
(03) 8387 2161
Fax
(03) 8387 2222
Email
gpliaison@mh.org.au
Address
The RMH Royal Park
34-54 Poplar Rd, Parkville, Victoria
Get directions
Related pages
Mental health referrals 
Medical patient direct referrals 
Last updated 21 March 2024