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:

Respiratory Clinics

Template

Date Effective

Word Doc

PDF

Best Practice

Medical Director

Respiratory Clinics                                                                              May 2020 Word PDF

NSW Templates

Template

Date Effective

Best Practice

Medical Director

Death Certificate (NSW)                                                                              June 2019

WNSW PHN Region-wide Templates

Template

Date Effective

Best Practice

Medical Director

Strong Minds Western - GP Referral and Mental Health Treatment Plan February 2020
Early Childhood Intervention Intake and Consent Form                                  April 2020
Marrabinya Referral Form May 2019

WNSW LHD Templates

Template

Location

Date Effective

Best Practice

Medical Director

LHD Geriatric Medicine Clinic Referral Form Western NSW LHD March 2019
LHD Integrated Chronic and Complex Care – Referral Form  Western NSW LHD March 2019
LHD Lung Cancer Fast Track Clinical Referral Western NSW LHD May 2019
LHD Bathurst High-Risk Foot Referral Bathurst November 2019
Bathurst After Hours Medical Service - Patient Form for RACF Visits Bathurst February 2018
LHD Dubbo Public Eye Clinic Dubbo April 2020
PRP Imaging Referral Dubbo April 2020
LHD Dubbo Fast Track Resp. Outpatient Clinic Dubbo January 2020
LHD Dubbo Respiratory LFT Referral Dubbo January 2020
Diabetes Shared Care Plan Template (Dubbo Diabetes Project)  Dubbo June 2017
Dubbo After Hours Medical Service - Patient Form for RACF Visits  Dubbo February 2018
LHD Dubbo High-Risk Foot Service Referral Form Dubbo October 2018
LHD Dubbo Neurophysiology Ambulatory Care Dubbo July 2018
Lourdes Hospital Hydrotherapy Referral Dubbo July 2018
Lourdes Hospital Pre-Admission Referral Dubbo July 2018
LHD Orange Referral positive FBOT for NBCSP Orange January 2020
Orana Mall Sleep Study Referral Form Dubbo October 2019
LHD Orange Colonoscopy Referral for Positive Faecal Occult Blood Test Orange February 2018
General Paediatrics at Orange Paediatric Clinic Referral Orange April 2020
LHD Dubbo Neurophysiology Study Referral Dubbo May 2020
LHD Dubbo Direct Access Scopes Dubbo May 2020
LHD Dubbo HITH PICC Dubbo June 2020

Far West LHD Templates

Template

Date Effective

Best Practice

Medical Director

Far West Referral to Outpatient Clinic                November 2019
Greenwich Far West Pain Clinic Referral Form May 2020
Greenwich Far West Pain Clinic Questionnaire May 2020
Greenwich Far West Pain Clinic Follow-Up May 2020

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Guide Dogs NSW/ACT Patient Referral Form