General Practice Colleague Referrals
Please complete this form to provide or update information regarding special interests and/or additional training or qualifications that you would like published on the ACT and SNSW HealthPathways General Practice Colleague Referrals page.
Name
*
Ms.
Mr.
Miss.
Mrs.
Dr.
Prof
A/Prof
Prefix
First Name
Last Name
In which State or Territory do you practise?
ACT
NSW
Please indicate which ACT practices you see patients:
If other, please specify (including practice address and contact details):
Do you have a special interest or additional training?
Yes
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If you will accept colleague referrals for a special interest, please specify below:
Accepting Colleague Referral
Practice(s)location
Training/Qualifications
Info for referrer/additional info
Aviation medicals
Contraception - Implant insertion/removal
Contraception - IUD insertion/removal
Dermatology (acne management, psoriasis etc.)
Dive and hyperbaric medicine
Drug and alcohol dependency
Fracture management (incl. cast removal)
Immunology and allergy assessment
Ingrown toenail surgery
IV Iron infusions
Musculoskeletal corticosteroid injections
Antenatal, Obstetrics and Gynaecology
Paediatric care
Palliative care and end of life care
Ring Pessary fit or change
Skin lesion removal or skin cancer screening
Sleep assessment
Human Immunodeficiency Virus Specialised Prescriber (s100)
Specialised surgical procedures (specify type of procedure in 'Additional information')
Surgical treatment of lip and/or tongue tie
Transgender health
Vasectomy
Breastfeeding Support
Circumcision - Male
Ear, Nose and Throat - ENT
Pre-employment Medical
Hypnosis
Obesity/diabetes and lifestyle interventions
Hepatitis B Specialised Prescriber
Sports Medicine Assesment
Women's Health General
Other
Please confirm that this information can be made available to other local health professionals on the ACT and SNSW HealthPathways site. This information will not be freely available to patients.
*
Yes
No
Submit
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