Some of our services and clinics have a preferred form or process for GPs and specialists 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).
The Royal Melbourne Hospital does not accept email referrals.
Standard referral form
Our standard referral form is used by the majority of our services and clinics:
Before faxing your referral
Virtual Specialist Consults (VSC) is an alternative to specialist clinic referrals. This statewide service offers timely specialist expertise for complex patients in the community.
Find out moreIf you want to refer a patient to us for care, make sure to include all required and requested information in your referral. This allows us to review and triage your request as efficiently as possible.
Find out moreSpecialty referral forms
The following files can be imported into your practice's referral system:
Related pages
Related pages
Order a Private Imaging referral pad
Complete the following order form and email it to radiologyreferralpadorder@mh.org.au with the subject line 'Referral pad order':