Required information
In order for us to be able to accept your patient for review and treatment, referring GP’s/Medical Specialists are required to provide the following detail in your referral.
Essential information
- full name
- address and phone numbers
- date of birth
- Indigenous status
- referring GP details
- health insurance details
- preferred language and interpreter requirements
- Medicare number
- mobility needs.
Referrer details
- name, address and contact information
- provider number
- signature
Referral details
- Date of referral
- Requested clinic
- General
- Menopause
- Pelvic pain
- Urogynaecology
- Endosurgery
- Adolescent
- Infertility
- Heavy gynaecological bleeding
- Oncology
- Name of specialist to whom the patient is being referred (for MBS-billed clinic)
Clinical information
Presenting problem and duration of symptoms
- GP diagnosis or provisional diagnosis, if known
- relevant medical history
- relevant social history or special needs
- current medications
- investigation results
- allergies or warnings
- physical examination results
- management to date and response to treatment.
Referral process
Our clinic is receiving eReferrals via HealthLink SmartForms. Please see our Refer a patient page for more information.
Step 1
Essential referral content will be checked. You will be contacted if further information is required.
Acknowledgement of referral receipt will occur within eight working days.
Immediate assessment or admission criteria:
Check criteria for immediate assessment or admission.
- severe, prolonged or heavy bleeding and concern for haemodynamic compromise
- imaging (U/S, CT or MRI) suggesting malignancy
- severe abdominal pain or pelvic pain
- torsion of the ovary (suspected or confirmed)
- ectopic pregnancy (suspected or confirmed).
Step 2
The referral will be triaged by the specialist areas according to clinical urgency.
This determines how long the patient will have to wait for an appointment.
Immediate assessment or admission criteria:
Contact the registrar on call via the switchboard: 03 8458 4444.
Step 3
Patients with urgent conditions are scheduled to be seen within 30 days.
Patients with non-urgent conditions are given the next available appointment according to clinical need.
Both the referrer and patient are notified.
Immediate assessment or admission criteria:
Contact the registrar on call via the switchboard: 03 8458 4444.
Immediate assessment criteria
Immediate assessment or admission criteria (not an exhaustive list)
Referrals to this service are assessed against the Statewide Referral Criteria. Please utilise HealthPathways to assist in making the referral. Referrals which do not meet the Statewide Referral Criteria will be declined.
Step 1: Check criteria for immediate assessment or admission.
- severe, prolonged or heavy bleeding and concern for haemodynamic compromise
- imaging (ultrasound, CT or MRI) suggesting malignancy
- severe abdominal pain or pelvic pain
- torsion of the ovary (suspected or confirmed)
- ectopic pregnancy (suspected or confirmed)
Step 2: Contact the registrar on call via the switchboard: 03 8458 4444.
Step 3: Follow up your phone call by sending your referral to the hospital including all relevant investigations.
Additional information
Specific Investigations: Gynaecological Conditions
Possible Diagnosis and Investigations
Abnormal cervical cytology
- current Pap smear
- HPV typing.
Adolescent presentations
- consider STI screen
- oelvic ultrasound (if performed)? Trans abdominal
- consider FBE/iron studies.
Cervical polyps
- current Pap smear.
Endometriosis
- pelvic ultrasound (if performed)
- current Pap smear.
Fibroid
- recent pelvic ultrasound
- FBE.
Infertility: primary/secondary or male factor infertility
- STI screen
- consider antenatal bloods
- FBC/ Rubella/ Varicella/ Hep C
- hormone profile
- FSH/ LH/ Prolactin / TSH
- semen analysis (if performed)
- consider referral for partner.
IUCD problems
- current Pap smear
- Chlamydia/gonorrhoea screen
- bacterial vaginosis screen
- consider pelvic ultrasound.
Menopause
- consider hormonal studies
- consider pelvic ultrasound
- consider FBE
- latest Pap smear.
Menorrhagia
- recent pelvic ultrasound report (if available )
- FBE; U&Es; Iron studies including HB (essential with referral)
- Thyroid function test
- current Pap smear (essential with referral)
- consider coagulation profile.
Ovarian cyst
- recent pelvic ultrasound
- consider tumour markers.
Pelvic floor dysfunction post-partum (MHW-MBS Clinic)
- recent pelvic ultrasound report (if performed)
- midstream urine.
Polycystic Ovarian Syndrome (PCOS)
- recent pelvic ultrasound
- hormone profile
- FSH/ LH/ Prolactin/ TSH.
Post-coital bleeding/intermenstrual bleeding
- current Pap smear including STI screening
- pelvic ultrasound
- tecent FBE; U&Es iron studies
- STI screen.
Post-menopausal bleeding
- current pelvic ultrasound
- current Pap smear
- recent FBE or iron studies.
Urinary incontinence
- MSU
- pelvic ultrasound (if performed)
- bladder diary.
Recurrent UTIs
- MSU.
Vulval conditions
- current Pap smear
- consider vulval biopsy.
Contact details
Referral contact details
Mercy Health
Gynaecology Clinic
163 Studley Road
Heidelberg Vic 3084
Phone: 03 8458 4111
Fax: 03 8458 4205
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