Get Hark Clinic

Filling out the Hark Clinic referral form is a vital step in ensuring that every child receives the appropriate care and support needed for their health, developmental, and behavioral needs. This guide will walk you through each section of the form to assist you in completing it accurately and thoroughly.

Follow the steps to successfully complete the Hark Clinic referral form.

1. Press the ‘Get Form’ button to obtain the form and access it in the editor.
2. Begin by providing the patient's personal details. Enter the first name, surname, date of birth (in dd/mm/yy format), and age for the current year. Indicate the patient’s gender by selecting 'Male’ or 'Female'.
3. Fill in the patient's address, ensuring all sections are completed accurately. If an interpreter is required, select 'Yes' or 'No' and specify the preferred language.
4. Complete the country of birth and the date of arrival in Australia, using the dd/mm/yy format. Include the Medicare number. If the patient is ineligible, indicate whether they are a client of applicable services such as IHMS, Life Without Barriers, or the Red Cross.
5. Select the migration status and visa type, if known. This section helps identify the patient's background.
6. In the 'Person to Contact' section, provide the contact's name, relationship to the child, email, and phone number. Specify whether an interpreter is required for this contact.
7. Detail the reason for referral in the designated section, including clinical findings, management history, and any special needs. Use the additional space provided if necessary.
8. Identify any medications that the patient is taking as well as any allergies they may have.
9. Record the GP or paediatrician's details, including their name, phone, fax, address, and provider number.
10. Sign the form where indicated. If the referrer is not a GP, provide their name, email, organization, and phone number.
11. Attach any relevant supporting documentation, including assessments and pathology results as needed. Ensure all paperwork is included.
12. Finalize the form by saving any changes, and choose to download, print, or share the document as necessary.

Complete and submit your Hark Clinic referral form online today to ensure timely care for your child.