Forms & Templates
Electronic forms & templates can save time by automatically filling in relevant patient data. Contact us to get help installing or using these forms.
There are loads more forms on our MBS/EPC page.
Medical Director
MedTech32
Genie
Locum
Zedmed
MS Word
PDF
Victorian Statewide Referral Form
The VSRF is a concise general-purpose template. Originally designed for communication between GPs and community based organisations (like Ballarat Community Health Centre and District Nursing), it can also be used when no other suitable form exists.
Hospitals
Ballarat Health Services (BHS):
- Outpatients referral: use the VSRF above
- Smoking Cessation Clinic referral

- Lymphoedema referral

- Fracture Clinic referral

St John of God Ballarat:
Other Hospitals:
- Alfred Hospital GP referral resources
- RCH Medical Director template on the NEVDGP web site
Specialists
- Dr Wayne Spring (sleep specialist)

- Ballarat Radiology Referral PDFs on A4 or A5
- Lake Imaging Referral PDFs on A4 or A5
- Pomegranate House / AAPS referral

Chronic Disease
CDM forms can now be found on our MBS/EPC page.
Other Forms
- City of Ballarat Disabled Parking Permit

- Victorian Workcover Certificate of Capacity

- HMR Referral

- RMMR Referral (MBS Item 903)

- VSRF - Consumer Consent

++ Prepared by Ballarat Group Practice from the following resources: Ballarat Group Practice Staff, BDDGP, Monash Division of General Practice, ADGP, Diabetes Foundation and the Heart Foundation.
