REFERRAL GUIDELINES: PHYSIOTHERAPY SERVICE
All patients referred to specialist clinics are assigned to a priority category based on their clinical need and related psychosocial factors. The
examples given are indicative only, and the clinician reviewing the referral will use their clinical judgement to determine the best service
response for the patient.
REFERRAL GUIDELINES: PHYSIOTHERAPY SERVICE
In order for us to be able to accept your patient for Physiotherapy Service review and treatment, referring GP’s / Medical Specialists are
required to provide:
Demographic
 Full name
 Address & phone numbers
 Date of birth
 Gender
 Preferred language and
interpreter requirements
 Medicare number
 Health insurance details
(where relevant)
 National healthcare identifier
(when established)
 Indigenous status (note
where applicable)
 Mobility needs
Updated: March 2015
Clinical
 Presenting problem, duration
of symptoms, and impact on
patient
 General practice diagnosis,
or provisional diagnosis, if
known
 Physical examination results
 Management to date and
response to treatment
 Investigation results
 Relevant medical history
 Relevant social history or
special needs
 Allergies or warnings
Referrers Details
 Name, address, and contact
information
 Name of general practitioner
(if different from referrer)
 Provider number
 Signature
Referral Details
 Date of referral
 Name of specialist to whom
the patient is being referred
(for MBS-billed clinics)
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REFERRAL GUIDELINES: PHYSIOTHERAPY SERVICE

Current medications
The Physiotherapy Service Referral Form is available to print and fax to 03 8458 4202.
REFERRAL PROCESS: PHYSIOTHERAPY SERVICE
STEP 1

STEP 2
Essential referral content will be checked. You The referral will be triaged by the specialist
will be contacted if further information is
unit according to clinical urgency.
required.
This determines how long the patient will have
to wait for an appointment.

STEP 3
Patients with urgent conditions are scheduled
to be seen within 30 days.
Patients with routine conditions are given the
next available appointment according to
clinical need.
Both the referrer and patient are notified.
REFERRAL PRIORITY: PHYSIOTHERAPY SERVICE
The clinical information provided in your referral will determine the triage category. The triage category will affect the timeframe in which that
the patient is offered an appointment.
Criteria

Existing patients of the hospital under care of a medical clinic
Updated: March 2015
Exclusions

Patients not under the care of a medical clinic of this hospital
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REFERRAL GUIDELINES: PHYSIOTHERAPY SERVICE

aged ≥ 16 years with symptoms of pelvic floor dysfunction,
prolapse, incontinence, or a pregnancy-related musculoskeletal
condition up to 8 weeks post-partum.
Neonates born at MHW with a musculoskeletal, neurological or
orthopaedic condition.


Post-natal patients with musculoskeletal conditions more than 8
weeks after delivery.
Non-pregnancy related musculoskeletal conditions – see
Orthopaedic and Musculoskeletal Physiotherapy.
INTERPRETING SERVICES
A proportion of our patients have limited or no proficiency in English. In these cases, we engage professional interpreters for communication
with our clinicians. To enable access to appropriate interpreting service, please ensure that your referral includes information on the preferred
language spoken by the patient and their need for an interpreter.
Mercy Health Physiotherapy Service
163 Studley Rd, Heidelberg, 3084
Phone: 03 8458 4141 Fax: 03 8458 4204
GP Hotline: 03 8458 4100
Updated: March 2015
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