Referral forms

Welcome to the referral forms page. There are two versions available. The first can be used by GPs, Specialists and other AHPs to refer patients for specific conditions. It is available as a PDF download. You then simply complete the form and fax to my clinic on (07) 4921 2539.

Download the PDF referral form for GPs, Specialists and other AHPs

This version of the referral form is most suited to insurers and other organisation wishing to refer a patient for Exercise Physiology services. Download the PDF form, compete and fax with reports as required to my clinic on (07) 4921 2539.

Download the PDF referral form for insurers and other organisations