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Referral Directory
REFERRAL DIRECTORY
All referrals for the
Adult Community Health Services
are to be directed to:
Gold Coast Adult Community Health
Via Medical Objects (Secure Transmission)
OR
Central Intake Unit (CIU)
FAX: 1300 668 536
DO NOT SEND TO BOTH
Telephone enquiries - 1300 668 936
Please ensure that all Pre-Requisite Tests ARE ATTACHED to your Referral (see clinic
specific pre-requisite tests).
Incomplete referrals WILL be returned and will delay patient categorisation and allocation of
appointments.
Referral Templates are available for download from
www.gpgc.com.au  Programs & Services  General Practice Liaison  Community Health 
Adult Community Health Service Directory
Please remind patient to bring to appointment:
 Medicare card
 Any concessions cards - (pension / health care / DVA/ PBS safety net / ADF etc.)
 Recent X-rays and Pathology results
 List of current medications, including dosages.
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Referral Directory
CHRONIC DISEASE
REHABILITATION
Chronic Disease Wellness Programs
are for complex patients.
Rehabilitation programs aim to increase
functional capacity and optimise quality
of life.
May include
 individual assessment
 screening
 treatment
 education
 exercise
May include
 individual assessment
 intervention
 education
 exercise sessions
 self management programs
HEALTHY AGEING
Healthy Ageing programs provide a
comprehensive, coordinated and
integrated range of maintenance and
support services.
Some programs are for HACC eligible
patients only
Duration of service may vary
The program aims to develop patient
capacity for self-management
Involvement is time limited, up to 12
weeks, with follow up as required.
Type 2 Diabetes or Pre Diabetes
Involvement is time limited, up to 12
weeks, with follow up as required.
Community Rehabilitation Program
Chronic Kidney Disease
Acquired Brain Injury
 stroke
 traumatic brain injury
 hypoxic brain injury
 brain tumour
 infection
 other neurological conditions
(excluding dementia and spinal
cord injury)
Heart Failure
 Exercise
 Education
Respiratory
 COPD
 Pulmonary Rehabilitation

Chronic Asthma (Nursing
only)
Complex Care
 Type 2 diabetes/CKD multi-
Cardiac Rehabilitation
MS Fitness Program
Falls and Balance Clinic
 Including a Falls and Balance
Intervention Program
Memory Clinic
Continence Advisory Service
STAR Group – Senior Therapy Activity
and Recreational Group/ Centre Based
Diversional Therapy
HACC eligible only
Home Care Domestic Services
HACC eligible only
disciplinary clinics
Indigenous Specific Chronic Disease
Services
 Mungulli Community Education
 Mungulli Wellness Clinic
 Indigenous Heart Health
A range of services are available to
existing CD Wellness Program
patients only including:
1. Mindfulness Training
2. Smoking Cessation
3. Appetite for Change (weight
management)
4. Advanced Health Care
Directives
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Referral Directory
CHRONIC DISEASE
SERVICE
REFERRAL INFORMATION
DIABETES
Eligibility
Chronic Disease Wellness Program –
formerly HEAL
Specialising in multi-disciplinary care
for patients with complex care needs;
supporting Team Care Arrangements
Dr Marlise Heynike
Dr Mark Forbes
Dr Nick Buckmaster
Enquiries:
Please call 1300 668 936 to speak with
a Diabetes Educator
Referrals for Type 1 Diabetes:
GPs need to forward a named referral,
addressed to –
Dr Peter Davoren
Diabetes Resource Centre
Fax: 56691251 or
Ph DRC on 56691250 to arrange an
appointment for your patient
This service is for patients 18 years and older with:
o A diagnosis of Type 2 Diabetes
or
o Pre-diabetes: a fasting plasma glucose >6.1 and < 7.0mmol or a 2 hours
glucose level following a 75g glucose load > 7.8mmol <11.1mmol/L.
Service Details
Referral Options Patients triaged at Central Intake:
- Direct into multidisciplinary group education
 Full day education 8.30-3.30 (lunch provided)
 4 one hour sessions over 4 weeks (Refreshments provided)
Multidisciplinary care
Type 2 Diabetes Education
Management of Type 2 Diabetes
Healthy Eating for Diabetes
Making Sense of Food Labels
Benefits of Physical Activity
Medication in Type 2 Diabetes
Healthy Feet
Self Management
Pre-Requisite Tests
Serial HbA1c
Fasting Blood Glucose/OGTT
Full Lipid Profile TG, HDL, LDL
A random urine albumin: Creatinine ratio
eGFR, FBE, LFTs, U&Es
Eye Screening Report – Optometrist (Optional)
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
Is this patient newly diagnosed?
Do you consider this person’s care needs are:
Low risk: can proceed directly to group education?
Complex care: has significant co-morbidity that requires full medical and multidisciplinary assessment and treatment planning?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindications to exercise>
Medical History.
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Referral Directory
CHRONIC DISEASE
SERVICE
REFERRAL INFORMATION
CHRONIC KIDNEY DISEASE
Eligibility
Chronic Disease Wellness Program –
formerly HEAL
This service is for patients 18 years and older with Chronic Kidney Disease
(eGFR<60ml/min) not requiring immediate Nephrologist review.
Service Details
Multidisciplinary Clinics
Specialising in multi-disciplinary care
for patients with complex care needs;
supporting Team Care Arrangements
Enquiries:
Please call 1300 668 936
Chronic Kidney Disease Education
Module 1 Understanding CKD
Cause
Progress
Common Symptoms
Complications
Management
Reducing Cardiovascular Risk
Module 2 CKD Self Management
What is Self Management?
Maintaining a Healthy Lifestyle
Healthy Eating with CKD
Common Medications in CKD
Safe Medication Practice
Living well with CKD
Family and Carer Needs
Module 3 CKD Treatment Options
Early Decision Making
What to consider
What are the options: Transplant,
Dialysis, Medical Care without
Dialysis
Patient Perspective
Pre-Requisite Tests
Serial blood pressure readings
Ultrasound of kidneys
Pathology tests:

eGFR (serial measures where available)

Urea

Creatinine

Electrolytes

Full Blood Count

Urine microscopy

Urine albumin or protein Creatinine ratio (serial values if
available)
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
Is this patient newly diagnosed?
Do you consider this person’s care needs are:
Low risk: requires education about kidney disease and health promotion
strategies
Complex care: has significant co-morbidity that requires comprehensive nurse
practitioner and multi-disciplinary assessment and treatment planning?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
< contraindications to exercise>
Medical History
Is this patient under the care of a Nephrologist?
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Referral Directory
CHRONIC DISEASE
SERVICE
REFERRAL INFORMATION
HEART FAILURE
Eligibility
Chronic Disease Wellness Program –
formerly HEAL
Specialising in multi-disciplinary care
for patients with complex care needs;
supporting Team Care Arrangements
including Heart Failure Medication and
Titration plans.
Prof Rohan Jayasinghe
Enquiries:
Please call 1300 668 936 to speak with
Clinical Nurse Consultant
 This service is for patients 18 years and older with clinical evidence of Heart Failure
with an Echocardiograph indicating:
-
Systolic Dysfunction
Diastolic Heart Failure
Right Heart Failure
Service Details
Heart Failure Education (12 week)
 Heart Failure and You
 Heart Failure Medication
 A Practical Guide to Food Choices
 Exercise and Leisure
 Tackling Tiredness
 Heart Failure and Intimacy





Stress and Relaxation
Decreasing Cardiac Risk Factors
Emotional Wellbeing and Your Heart
Partner Issues and Support Services
Heart Failure Device Therapy
Heart Failure Exercise: (12 week)
Following medical clearance, client is assessed by the Cardiac Nurse and
Physiotherapist. The Physiotherapist designs a Graded Exercise program. Programs
target both low functioning patients (home exercise programs) and higher functioning
patients (centre based gym programs)
Pre-Requisite Tests
ECG within last 3 months
Echocardiogram
Coronary Angiography Results
Coronary Artery Bypass Graft Reports
Pathology Results
Chest X-Ray
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
Is this patient newly diagnosed?
Do you consider this person’s care needs are:
Low risk: can proceed directly to group education?
Complex care: has significant co-morbidity that requires full medical and multidisciplinary assessment and treatment planning?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindications to exercise>
Medical History
Is this patient under the care of a cardiologist?
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Referral Directory
CHRONIC DISEASE
SERVICE
REFERRAL INFORMATION
RESPIRATORY
Eligibility
Chronic Disease Wellness Program –
formerly HEAL
Specialising in multi-disciplinary care
for patients with complex care needs,
Supporting Team Care Arrangements
and COPD/Asthma Action Plans
Dr Siva J Sivakumaran
Dr Toby Tang
Dr Maninder Singh
Dr Kugathasan Mutalithas
Enquiries:
Please call 1300 668 936 to speak with
the Clinical Nurse Consultant –
Respiratory
Pulmonary Rehabilitation
1.
Multi-disciplinary Group
Education
2.
Home Exercise
Programs/Group Exercise
This service is for patients 18 years and older with:
 a confirmed diagnosis of COPD (who require multi-disciplinary care) or
 a confirmed diagnosis of Chronic Asthma
Have you excluded Lung Cancer, Interstitial Lung Disease, Cardiac Disease associated
breathlessness, Pulmonary Arterial Hypertension, Pulmonary Embolism?
If No, refer to Specialist Outpatients Department using template available on GPGC
website
Service Details
Pulmonary Rehabilitation Education:
 Exercise benefits, Home exercises
 What is COPD
 Community Programs: RCC, LARF,
 Breathing Awareness and Control
CDSM, HACC service
 Healthy Eating
 Incontinence
 Swallowing
 Medications
 Oxygen use
 Review Breathing, Chest Clearance,
 Energy Conservation
COPD Action Plan
 Identifying and Managing Depression
 Coping with Chronic illness, motivation
and Anxiety
Pulmonary Rehabilitation Exercise
Following medical clearance, client is assessed by the Respiratory Physiotherapist who
designs a Graded Exercise program. Programs target both low functioning patients
(home exercise programs) and higher functioning patients (centre based gym programs)
Pre-Requisite Tests
COPD
Spirometry
Electrocardiogram (ECG) within
last 3 months
Bloods within last 3 months
Chest X-Ray
CT Chest if available
Chronic Asthma
Pre and post SABA Spirometry
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
Is this patient newly diagnosed?
Do you consider this person’s care needs are:
Low risk: can proceed directly to group education?
Complex care: has significant co-morbidity that requires full medical and multidisciplinary assessment and treatment planning?
Do you have any concern regarding this patient participating in a graded exercise
program?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindicates to exercise>
Medical History
Is this patient under the care of a respiratory physician?
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Referral Directory
CHRONIC DISEASE
SERVICE
REFERRAL INFORMATION
COMPLEX CARE
Eligibility
Chronic Disease Wellness Program
recognises the need for coordinated
care for clients with multiple chronic
health conditions and psychosocial
barriers to health.
Current Complex Care Services:
1. Joint Type 2 Diabetes and CKD
Clinics (conducted by specialist nurses
Diabetes, CKD, Pharmacy and
Dietitian) with
a. Case consultation with
physicians
b. onward referral capacity to
full multi-disciplinary team
Please call 1300 668 936 to speak with
the Clinical Nurse Consultant –
Diabetes
This service is for patients 18 years and older with:
 a confirmed diagnosis of Type 2 Diabetes and CKD (who require multidisciplinary care)
Pre-Requisite Tests
As for CKD
As for Type 2 diabetes
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
Is this patient newly diagnosed?
Do you consider this person’s care needs are:
Low risk: can proceed directly to group education?
Complex care: has significant co-morbidity that requires full medical and multidisciplinary assessment and treatment planning?
Do you have any concern regarding this patient participating in a graded exercise
program?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindications to exercise>
Medical History
 .
Is this patient under the care of a Nephrologist or Endocrinologist?
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Referral Directory
CHRONIC DISEASE
SERVICE
REFERRAL INFORMATION
INDIGENOUS HEART HEALTH
Eligibility
An early intervention Cardiac screening
clinic attended by an Advanced
Cardiology Trainee and multidisciplinary team targeting Indigenous
community members with high
cardiovascular risk factors.
Patient identifies as being of Aboriginal and/or Torres Strait Islander descent and
aged 16 years and older.
Pre-Requisite Tests
Patients with recent MI: refer directly
to Cardiac Rehabilitation .
Cardiovascular Risk Factors indicate high risk eg smoking, diabetes or high risk
as calculated using a risk assessment tool.
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
Patients with a diagnosis of Heart Please ensure any current GPMP/TCA is attached
Failure i.e. clinical evidence of Heart
Failure
with
Echocardiograph Had this patient been referred for Close the Gap medication assistance?
indicating:
Is this patient newly diagnosed?
a) Systolic Dysfunction
b) Diastolic Heart Failure
Do you consider this person’s care needs are:
c) Right Heart Failure
Low risk: needs likely to be met in group education.
Complex care: has significant co-morbidity that requires full medical and multirefer directly to the Chronic Disease
disciplinary assessment and treatment planning?
Wellness Program Heart Failure
Service.
Note patients with low risk factors
can be referred to Mungulli Community
Education to support lifestyle change.
Do you have any concern regarding this patient participating in

General community physical activity programs

A graded exercise program under the guidance of a Physiotherapist or
Exercise Physiologist
Enquiries:
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
Please call 1300 668 936
<contraindicates to exercise>
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Referral Directory
CHRONIC DISEASE
SERVICE
REFERRAL INFORMATION
MUNGULLI WELLNESS
CLINIC
Eligibility
A culturally safe chronic disease
assessment and management clinic
for community members with early
signs, symptoms and/or a diagnosis
of
 Respiratory disease
 Chronic kidney disease or
 Type 2 diabetes/pre- diabetes
and related chronic conditions.
Enquiries:
Please call 1300 668 936
Patient identifies as being of Aboriginal and/or Torres Strait Islander descent and
aged 16 years and older.
Pre-Requisite Tests
Chronic Asthma/Chest Infections
Pre and post SABA Spirometry
COPD
Spirometry
Electrocardiogram (ECG) within last 3
months
Bloods within last 3 months
Chest X-Ray or CT Chest if available
Type 2 Diabetes/Pre-diabetes
Serial HbA1c
Fasting Blood Glucose/OGTT
Full Lipid Profile TG, HDL, LDL
A random urine albumin:Creatinine ratio
eGFR, FBE, LFTs, U& Es
Eye Screening Report – Optometrist
(Optional)
CHRONIC KIDNEY DISEASE
Serial blood pressure readings
Ultrasound of kidneys
Pathology tests:
eGFR (serial measures where available)
Urea
Creatinine
Electrolytes
Full Blood Count
Urine microscopy
Urine albumin or protein Creatinine ratio
(serial values if available)
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
Had this patient been referred for Close the Gap medication assistance?
Is this patient newly diagnosed?
Do you consider this person’s care needs are
 Low risk : needs likely to be met in group education
 Complex care: has significant co-morbidity or barriers to health outcomes
that requires full medical and multi-disciplinary assessment and treatment
planning
Do you have any concern regarding this patient participating in
 General community physical activity programs
 A graded exercise program under the guidance of a
Physiotherapist or Exercise Physiologist
Does this patient have co morbidities that restrict what exercise can be encouraged
during group or individual education?
<contraindications to exercise>
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Referral Directory
CHRONIC DISEASE
SERVICE
REFERRAL INFORMATION
MUNGULLI COMMUNITY
EDUCATION
Eligibility
Mungulli education offers a culturally
safe initial contact point for community Patient identifies as being of Aboriginal and/or Torres Strait Islander descent and
members and supports patient flow into is aged 16 years and older
early interventions and chronic disease
Pre-Requisite Tests
management services. General health
and chronic disease prevention
No medical information is required
education with opportunity to identify
risk factors
Enquiries:
Specific considerations for referral (please indicate on referral)
Please call 1300 668 936
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Referral Directory
CHRONIC DISEASE
The following services may be offered to patients referred for multi-disciplinary chronic disease
programs
Direct referral is not available
Generic Chronic Disease
Services
Service Information
Mindfulness for Mood Enhancement
Patients are invited to an information session on Mindfulness and if
– M4ME
interested, enrol in a 7 week program aimed at managing the comorbidities of anxiety and depression.
Smoking Cessation
Patients are offered evidence-based smoking cessation support based
upon the Bittoun method, including access to counselling depending on
the severity of addiction. The GP is consulted and assumes prescription
of related pharmacology. The patient is monitored for 12 weeks.
Appetite for Change
A 4 week behavioural weight management program, offered monthly.
Advanced Health Directives
An education session explaining the importance of Advanced Health
Directives.
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Referral Directory
Contraindications to Exercise
For all Chronic Disease Wellness Programs
Please advise all contraindications to exercise that apply to your patient using the following reference Relative contraindications can be superseded if benefits outweigh risks of exercise. In some instances,
these individuals can be exercised with caution and/or using low-level end points, especially if they are
symptomatic at rest.1
1
ACSM’s Guidelines for exercise testing and prescription. Eight editions. 2010 American College of Sports
medicine. Wolters Kluwer Lippincott Williams and Wilkins (publishers)
Absolute contraindications
A recent significant change in the resting
ECG suggesting significant ischemia, recent
myocardial infarction (within 2 days) or other acute
cardiac event
Unstable Angina
Uncontrolled cardiac dysrhythmias causing
symptoms or hemodynamic compromise
Symptomatic severe aortic stenosis
Relative contraindications
Left main coronary stenosis
Moderate stenotic valvular heart disease
Electrolyte abnormalities (eg. Hypokalemia,
hypomagnesaemia
Severe arterial hypertension (i.e. systolic BP
of >200mm Hg and/or a diastolic BP of >110mm Hg)
at rest
Tachydysrhythmia or bradydysrhythmia
Uncontrolled symptomatic heart failure
Acute pulmonary embolus or pulmonary
infarction
Hypertrophic Cardiomyopathy and other forms
of outflow tract obstruction
Neuromuscular, musculoskeletal or
rheumatoid disorders that are exacerbated by exercise
Acute myocarditis or pericarditis
Suspected or known dissecting aneurysm
Acute systemic infection, accompanied by
fever, body aches or swollen lymph glands
High-degree atrioventricular block
Ventricular aneurysm
Uncontrolled metabolic disease (eg. Diabetes,
thyrotoxicosis or myxedema)
Chronic infectious disease (eg mononucleosis,
hepatitis, AIDS)
Mental or physical impairment leading to
inability to exercise adequately
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Referral Directory
REHABILITATION
SERVICE
REFERRAL INFORMATION
COMMUNITY REHABILITATION
PROGRAM
Eligibility
Community Rehabilitation Program
provides a goal oriented multi-disciplinary
rehabilitation service for adult patients who
have an acquired brain injury.
The service delivers a patient centred
holistic model of restorative and adaptive
therapy, focussed upon improving the
patient’s level of functioning and
participation and optimising quality of life.
Assessment and therapy services are
provided either at the Robina Health
Precinct or within the patient’s home.
This service provides a 12 week, multi-disciplinary rehabilitation service for
patients aged 18 to 65 years with:
Acquired Brain Injury, including:
 Stroke
 Traumatic Brain Injury
 Hypoxic Brain Injury
 Brain Tumour
 Infection
 Other neurological conditions (excluding dementia and spinal cord
injury)
Pre-Requisite Tests
Patients require referral to a minimum of
two or more allied health disciplines.
The multi-disciplinary team includes:
- Physiotherapy
- Occupational Therapy
- Speech Pathology
- Dietician
-
Social Work
Neuropsychology
Enquiries:
Please call 1300 668 936
Recent brain CT/MRI
Mental Health care plan (if appropraite)
Full Blood count
Cholesterol
U&E
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
How long has the patient had this diagnosis or are they newly diagnosed?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindications to exercise>
Do you consider this person’s care needs are
 Low risk: patient is medically stable and able to participate in multidisciplinary and community based rehabilitation
 Complex care: has significant co-morbidity or requires additional
medical and multi-disciplinary assessment and treatment planning (can
access rehab consultant but this is not a primary part of service at this
time)
Medical History
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Referral Directory
REHABILITATION
SERVICE
REFERRAL INFORMATION
CARDIAC REHABILITATION
Eligibility
Specialising in multi-disciplinary care
for patients with complex care needs;
assisting patients with cardiovascular
disease return to optimal health and an
active lifestyle aimed at reducing the
risk of further cardiac events.
Prof Rohan Jayasinghe
Enquiries:
Please call 1300 668 936
This service is for patients/patients 18 years and older with:
 Medically stable post Myocardial Infarction (>2-3 weeks post NSTEMI; 3-4
weeks post STEMI); with or without Percutaneous Coronary Intervention (PCI)
 PTCA elective intervention (>2 weeks post PCI)
 Stable angina
 CABG surgery (>4 weeks post CABG)
 Valvular surgery (>4 weeks post surgery)
 Pacemaker and ICD insertion (>4 weeks post surgery)
 Compensated Congestive Heart Failure
 Stable Cardiomyopathy
 Heart transplant (>4 weeks post surgery)
 Cardiovascular disease
 High risk factor profile
Pre-Requisite Tests
Please include copies of any relevant reports or results including :
Coronary angiography
Myocardial perfusion scan
Echocardiography
Exercise stress test
Lipids
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
How long has the patient had this diagnosis or are they newly diagnosed?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindications to exercise>
Medical History
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Referral Directory
REHABILITATION
SERVICE
REFERRAL INFORMATION
MS FITNESS
Eligibility
The MS Fitness program is offered
across the three Community Health
centres; Helensvale, Robina Precinct
and Palm Beach. The program’s aim is
to offer exercise to maintain muscle
endurance, strength and flexibility.
Individual assessment areas of muscle
weakness, abnormalities in gait and
muscle tension are addressed through
individualised exercise prescriptions
which patients perform within a group
based format.
This service is for patients 18 years and older with Multiple Sclerosis or Chronic
Inflammatory Demyelinating Polyneuropathy (CIDP), who are independently
mobile or require unilateral support to walk up to 8m.
0
1
2
3
Normal
Mild Disability
Moderate Disability
Early Cane
MS Fitness Program
4
Late Cane
Patients more severely impacted, or who are wheelchair bound should be
referred to Fran Shermann (MS Society Regional Coordinator for Logan and Gold
Coast on 3840 0844)
Clients are assessed on the Disease Steps Scale
Functionally normal with no limitations on activity or lifestyle
Mild symptoms and/or signs
Main feature is a visibly abnormal gait
Use a cane/unilateral support for greater distances, but can walk at least
25 ft without it
Unable to walk 25 feet without a cane/unilateral support
MS Program Coordinator; Accredited
Exercise Physiologist
Disease steps scale 3 and above are eligible for MS Fitness Program. 4 on scale
are considered on individual basis. 5 and above catered for through MS society
physio one day a week at Robina Community Health.
Enquiries:
5
6
U
Please call 1300 668 936
Bilateral Support
Wheelchair
Unclassifiable
Require bilateral support to walk 25 feet
Essentially confined to wheelchair
Used for patients who do not fit above classification
Reason for U assignments included overwhelming fatigue or severe cognitive,
visual, or bladder/bowel impairment out of proportion to otherwise minor physical
disability.
Sustained worsening of at least two steps on Disease Steps over a 1 year period
would indicate treatment failure and the need for specialist review.
Pre-Requisite Tests
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
It is not a requirement of the program that a TCA is completed. GPMP/TCA can
be reversed for any private provider referrals that may be required throughout the
year.
How long has the patient had a history of MS or are `they newly diagnosed?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindications to exercise>
Medical History
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Referral Directory
HEALTHY AGEING
SERVICE
REFERRAL INFORMATION
FALLS AND BALANCE CLINIC
Eligibility
The Falls and Balance Clinic provides
multi-disciplinary input for patients
identified as having high falls risk, or have
had recent falls.
Aside from medical assessments, the Falls
and Balance Clinic patients undergo a
comprehensive medication review
conducted by a pharmacist in conjunction
with a geriatrician, as well as having
access to a specialist physiotherapist, with
expertise in musculoskeletal as well as
vestibular physiotherapy.
Specialist Geriatricians:
Dr Ben Chen
Dr Suba Kumar
Dr Margaret Bilska
Physiotherapist – Leia Barnes
Pharmacist – Carly Dowling
Enquiries:
Please call 1300 668 936
Recent recurrent falls or near falls (>3 episodes over past year), and/or
Significant balance or gait instability, and/or
Falls with significant complications (skin tears, extensive soft tissue bruising or
fractures) and/or
Falls with presentations to GP or Emergency Department.
Please note: if the patient does not require investigation and would benefit
from therapy provided by Allied Health professionals (including the Finding Your
Feet program), then refer to Falls and Balance Intervention Program.
Pre-Requisite Tests
FBC
E/LFT
TSH
B12
Folate
Magnesium
Any of the following test results if undertaken in the past 12 months
Radiology - CT Head, XR Spine, Bone Densitometry, ECHO, Holter, EEG, EMG,
Nerve conduction study
Please attach any previous specialist or allied health reports eg Neurology,
Cardiology, Rheumatology, Physiotherapy
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
It is not a requirement of the program that a TCA is completed. GPMP/TCA can
be reversed for any private provider referrals that may be required throughout the
year.
How long has the patient had this diagnosis or are they newly diagnosed?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindications to exercise>
Medical History
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Referral Directory
HEALTHY AGEING
SERVICE
REFERRAL INFORMATION
MEMORY CLINIC
Eligibility
The Memory Clinic provides a
comprehensive, multi-disciplinary
diagnostic and intervention service for
patients suffering from dementia and other
cognitive disorders.
Aside from medical diagnosis, the Memory
Clinic provides nursing and allied health
inputs into supporting the social,
psychological and care dimensions of
managing dementia.
Specialist Geriatricians:
Dr Ben Chen
Dr Suba Kumar
Dr Margaret Bilska
Dr Mohammed Khateeb
Dr Elizabeth Rothstadt
Enquiries:
Please call 1300 668 936
This service is for people, 45 years and over experiencing “cognitive problems”
(requiring diagnosis and treatment) characterised by progressive cognitive
decline, and/or memory impairment not in relation to personality disorders, illicit
drug use, DSM IV Axis I Clinical Disorders, pre-existing brain injury (e.g. recent
TBI).
Pre-Requisite Tests
FBC
E/LFT
B12
Folate
TSH
MSU
CRP
Magnesium
Phosphate
CT Head – attach result if performed in last 12 months.
Please attach any previous specialist or allied health reports eg Neurology,
Cardiology, Rheumatology, Physiotherapy
Specific considerations for referral (please indicate on referral)
Is a Team Care Arrangement requested?
It is not a requirement of the program that a TCA is completed. GPMP/TCA can
be reversed for any private provider referrals that may be required throughout the
year.
How long has the patient had this diagnosis or are they newly diagnosed?
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindications to exercise>
Medical History
Developed in Partnership between General Practice Gold Coast and Adult Community Health July 2012
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Referral Directory
HEALTHY AGEING
SERVICE
REFERRAL INFORMATION
HACC SERVICES
Eligibility
This service is for patients/patients 18
years and older who are HACC eligible.
Services include:
HACC Eligible Patients Only – A frail older person with a moderate to severe disability,
a younger person with a moderate to severe disability, or a carer for either of the above
persons, requiring support to be more independent at home and in the community,
thereby enhancing their quality of life and/or preventing their inappropriate admission to
long term residential care.
Continence Advisory Service Patient has significant continence issues
that have resulted in falls or other medical
issues e.g. multiple UTIs, requiring multidisciplinary assessment and treatment.
Pre-Requisite Tests
Falls and Balance Intervention Program
in Community Health Centres
Specific considerations for referral (please indicate on referral)
Patient does not require investigation
and would benefit from therapy
provided by Allied Health professionals
(including Finding Your Feet program).
See Falls and Balance referral form for
other options.
Is a Team Care Arrangement requested?
It is not a requirement of the program that a TCA is completed. GPMP/TCA can
be reversed for any private provider referrals that may be required throughout the
year.
STAR Group
Senior Therapy Activity and Recreational
Group/Centre based Diversional Therapy.
Does this patient have co morbidities that restrict what exercise can be
encouraged during group or individual education?
<contraindications to exercise>
Home Care Domestic Services
Medical History
Patient requires domestic assistance
(fortnightly service)
How long has the patient had this diagnosis or are they newly diagnosed?
Enquiries:
Please call 1300 668 936
Developed in Partnership between General Practice Gold Coast and Adult Community Health July 2012
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