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

MR-280 Inpatient Services Referral.pdf

Hospital in the Home (HITH) Referral

All referrals to be sent to the HITH Team via email (preferred method): hith@basscoasthealth.org.au

General Enquiries to (03) 5671 3439

MR-302 Hospital in the Home - Medical and Iron Infusion Referrals.pdf

Outpatient Services Referral

All referrals to be sent to the BCH Access Team via Fax (preferred method for referrals from outside of BCH) or email (preferred method for referrals from BCH employees): Fax: (03) 9102 5307 or Access@basscoasthealth.org.au.
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

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

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

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

Supported Playgroups | Contact: 0427 729 695

Volunteer Transport Program | Contact: 5671 3372

Referral Documents

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