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 26.4.24 (1).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 Form

MR-309 Outpatient specialist clinic referral.pdf

| Cardiology Referral Form

MR-310 Rapid Access Cardiology Referral.pdf

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 MR-309 Outpatient specialist clinic referral.pdf
Continence Service
Dermatology	Document MR-309 Outpatient specialist clinic referral.pdf
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 MR-313 Ambulatory Care Referral Aug 2024.pdf
Emergency Relief	Document Ambulatory Care Referral Form (MR-313)
Gastroenterology	Document MR-309 Outpatient specialist clinic referral.pdf
General Surgery	Document MR-309 Outpatient specialist clinic referral.pdf
Geriatric Medicine	Document MR-309 Outpatient specialist clinic referral.pdf
Gynaecology	Document MR-309 Outpatient specialist clinic referral.pdf
Haematology	Document MR-309 Outpatient specialist clinic referral.pdf
Integrated Chronic Disease Management (ICDM)	Document MR-313 Ambulatory Care Referral.pdf
Lymphoedema Management	Document Ambulatory Care Referral Form (MR-313)
Nephrology	Document MR-309 Outpatient specialist clinic referral.pdf
Neurosurgery consultations only	Document MR-309 Outpatient specialist clinic referral.pdf
Occupational Therapy	Document Ambulatory Care Referral Form (MR-313)
Older Person's Nurse Practitioner	Document Ambulatory Care Referral Form (MR-313)
Oncology	Document MR-309 Outpatient specialist clinic referral.pdf
Ophthalmology	Document MR-309 Outpatient specialist clinic referral.pdf
Orthopaedic Surgery	Document MR-309 Outpatient specialist clinic referral.pdf
Orthotist	Document Ambulatory Care Referral Form (MR-313)
Palliative Care	Document MR-309 Outpatient specialist clinic referral.pdf
Physiotherapy	Document Ambulatory Care Referral Form (MR-313)
Plastic Surgery	Document MR-309 Outpatient specialist clinic referral.pdf
Podiatry	Document Ambulatory Care Referral Form (MR-313)
Radiation Oncology	Document MR-309 Outpatient specialist clinic referral.pdf
Respiratory & Sleep	Document MR-309 Outpatient specialist clinic referral.pdf
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)
Urology	Document MR-309 Outpatient specialist clinic referral.pdf