Referral Form

BCH Referral Information

Bass Coast Health (BCH) provides a wide range of services – please see below the preferred method of referral to each individual service.

Inpatient Services Referral

All referrals to be sent to the Patient Flow & Access Coordinator: Ph: 03 5671 3384 Fax: 03 5671 3321

BCH Inpatient Service Referral Form.pdf

Outpatient Services Referral

All referrals to be sent to the BCH Access Team via email (preferred method): Access@basscoasthealth.org.au or Fax: (03) 9102 5307. General Enquires to (03) 5671 3175.

Outpatient Specialist Clinic Referral (MR-309)

| Outpatient Specialist Clinic Referral Form

Rapid Access Cardiology Referral (MR-310)

| Cardiology Referral Form

Mandatory referral information required includes:

a minimum of 3 client identifiers
relevant medical/social history
presenting issues/goals
discharge summaries (as relevant)
Medicare details
Local GP name and contact number

Referrals via Australian Community Support Organisation (ACSO) | 1300 022 760Alcohol and other Drugs Services

Pharmacotherapy | aod.intake@basscoasthealth.org.au

Family Day Care | Contact 5671 3301 or familydaycare@basscoasthealth.org.au

Family Services | Referrals via The Orange Door: 1800 319 354

Supported Playgroups | Contact: 0427 729 695

Volunteer Transport Program | Contact: 5671 3372

Meals On Wheels | Contact: 5671 3247 or mealsonwheels@basscoasthealth.org.au

Referral Documents

Asthma and Pulmonary Rehabilitation	Document Ambulatory Referral Form (MR-313)
Breast Care Nurse (The McGrath Foundation)	Document Ambulatory Referral Form (MR-313)
Cardiac Rehabilitation	Document Ambulatory Referral Form (MR-313)
Cardiology	Document Rapid Access Cardiology Referral (MR-310)
Continence Service	Document Ambulatory Referral Form (MR-313)
Dermatology	Document Outpatient Specialist Clinic Referral (MR-309)
Diabetes Education	Document Ambulatory Referral Form (MR-313)
Dietetics	Document Ambulatory Referral Form (MR-313)
Disability Planning	Document Ambulatory Referral Form (MR-313)
District Nursing and Palliative Care	Document Ambulatory Referral Form (MR-313)
Emergency Relief	Document Ambulatory Referral Form (MR-313)
Gastroenterology	Document Outpatient Specialist Clinic Referral (MR-309)
General Surgery	Document Outpatient Specialist Clinic Referral (MR-309)
Geriatric Medicine	Document Outpatient Specialist Clinic Referral (MR-309)
Gynaecology	Document Outpatient Specialist Clinic Referral (MR-309)
Haematology	Document Outpatient Specialist Clinic Referral (MR-309)
Integrated Chronic Disease Management (ICDM)	Document Ambulatory Referral Form (MR-313)
Lymphoedema Management	Document Ambulatory Referral Form (MR-313)
Nephrology	Document Outpatient Specialist Clinic Referral (MR-309)
Occupational Therapy	Document Ambulatory Referral Form (MR-313)
Older Person's Nurse Practitioner	Document Ambulatory Referral Form (MR-313)
Oncology	Document Outpatient Specialist Clinic Referral (MR-309)
Orthopaedic Surgery	Document Outpatient Specialist Clinic Referral (MR-309)
Orthotist	Document Ambulatory Referral Form (MR-313)
Physiotherapy	Document Ambulatory Referral Form (MR-313)
Podiatry	Document Ambulatory Referral Form (MR-313)
Radiation Oncology	Document Outpatient Specialist Clinic Referral (MR-309)
Social Support Groups	Document Ambulatory Referral Form (MR-313)
Social Work	Document Ambulatory Referral Form (MR-313)
Speech Pathology	Document Ambulatory Referral Form (MR-313)
Stomal Therapy	Document Ambulatory Referral Form (MR-313)
Stop Smoking Support	Document Ambulatory Referral Form (MR-313)