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
- date of birth
- referring GP details and provider number
- preferred language and interpreter requirements
- Medicare number
- mobility needs.
- date of delivery
- details of perineal injury
- associated symptoms
- obstetric/ gynaecological/ surgical history.
If injury occurred elsewhere please request delivery information and information regarding the repair.
Investigations and results
- results of any previous investigations
- referral to pelvic floor physiotherapy prior to attendance desirable.
Populate required information on the perineal clinic referral form, then print and fax to the relevant outpatient department on 03 8458 4878.
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.
The referral will be triaged by the specialist unit according to clinical urgency.
This determines how long the patient will have to wait for an appointment.
Patients with routine conditions are given the next available appointment according to clinical need.
Both the referrer and patient are notified.
Referral contact details
Mercy Health Perineal Clinic
Department of Urogynaecology
Level 6, 163 Studley Road
Heidelberg Vic 3084
Phone: 03 8458 4500
Fax: 03 8458 4878
Donate to the Mercy Health Foundation
The Mercy Health Foundation supports programs to improve the health and wellbeing of those in need. Your donation makes a difference in hospitals, nurseries, aged care homes, and the general community.
We value feedback from the people we care for, including from your families, friends, carers, and our broader community. Find out how to register a concern, complaint or compliment, or make a suggestion for improvement at Mercy Health.