Please see below a list of templates available from this website or via external provider websites.

Please note: Western Victoria PHN (WVPHN) welcomes the opportunity to provide online links to GP Referral Templates for specialists or primary health care services in our region. If you wish to have a link to your referral form included on this page, please email communications@westvicphn.com.au with the web address and title of the form. Unfortunately, we are unable to host non-WVPHN forms directly on our website.

Alcohol and other drugs

Chronic conditions

Cancer Supportive Care GPMP

Diabetes tool

General practice support

Hospitals and health services referrals and templates

Mental health

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Psychological Therapy Services referrals

Psychosocial Support Program referrals

Specialists referrals

Last modified: 23 January, 2020