Templates for General Practice 

The following templates are for General Practice to download into their CIS.

Please access the relevant instruction sheets for information on how to import these templates to your program of choice:

TemplateDate as ofBest PracticeMedical Director
Bathurst After Hours Medical Service - Patient Form for RACF Visits February 2018
Colonoscopy Referral for Positive Faecal Occult Blood Test February 2018
Death Certificate (NSW)

June
2019

Diabetes Shared Care Plan Template (Dubbo Diabetes Project)  June 2017
Dubbo After Hours Medical Service - Patient Form for RACF Visits  February 2018
Dubbo High Risk Foot Service Referral Form - Western NSW LHD October 2018
Dubbo Neurophysiology Ambulatory Care - Western NSW LHD July 2018
Geriatric Medicine Clinic Referral Form March 2019
Integrated Chronic and Complex Care – Referral Form  March 2019
Lung Cancer Fast Track Clinical Referral - Western NSW LHD May
2019
Marrabinya Referral Form

May
2019


Strong Minds Western - GP Referral and Mental Health Treatment Plan October 2017
Lourdes Hospital Hydrotherapy Referral July 2018
Lourdes Hospital Pre-Admission Referral July 2018
Orana Mall Sleep Test Referral Form July 2018
Request for Endoscopy - Western NSW LHD July 2018
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