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The following referral templates are available to download.

Referral Templates - St Vincent's Specialist Clinics:

Best Practice Referral Template
Zedmed Referral Template
Medical Director Referral Template

Paper version:
St Vincent's Referral Template (Specialist Clinics) 

Victorian Statewide Referral Forms:
Victorian Statewide Referral Form - Medical Director
Victorian Statewide Referral Form - paper version 
Victorian Statewide Referral Form + Urology
Victorian Statewide Referral Form + Osteoarthritis Hip and Knee 

NEW - Aged Care and Community Services Referral Form
Best Practice Referral Template
Medical Director Referral Template
ZedMed Referral Template
Paper version - Aged Care and Community Services Referral

- This referral template is for the following services:
Aged Psychiatry Assessment and Treatment Team (APATT)
Community Rehabilitation Centres
HARP (Hospital Admission Risk Program)
Home-Based Allied Health
Polio Services Victoria
Specialist Clinics for Older Persons
Young Adults Complex Disability Service

Other forms:


Pathology request form

Request information from Health Information Services (medical records)

Specialist Clinics Patient Transport Request Form

41 Victoria Parade, Fitzroy VIC 3065, Australia. Phone: (03) 9288 2211