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.
- full name
- address and phone numbers
- date of birth
- Indigenous status
- referring GP details
- health insurance details
- preferred language and interpreter requirements
- Medicare eligibility & number
- mobility needs
- advanced care plan
- medical power of attorney.
Populate required information on the referral form then print and fax to 03 9364 9198.
Referral contact details
Mercy Palliative Care
3 Devonshire Road
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