Get Marrabinya Referral Form - Home Maari Ma Health

Filling out the Marrabinya Referral Form is a crucial step for Indigenous patients seeking chronic disease management services. This guide provides clear and supportive instructions to help users navigate the online form effectively.

Follow the steps to complete the Marrabinya Referral Form accurately.

1. Press the ‘Get Form’ button to access the Marrabinya Referral Form and open it in your preferred online editor.
2. Begin by entering the practice or Aboriginal Community Controlled Health Organisation (ACCHO) details in the Practice Details section. Fill in the name, address, email, phone number, and fax number as required.
3. Provide the information for the Contact Worker and Referring GP, specifying whether the GP is a locum or belongs to a regular practice.
4. In the Patient Details section, enter the patient's name, address, date of birth, and contact numbers, including Medicare information if applicable.
5. Indicate whether the patient identifies as Aboriginal or Torres Strait Islander. If they answer 'No', they are not eligible for the service.
6. Confirm if the patient is enrolled for chronic disease management and if they have a current GP Management Plan (GPMP). If the answer is 'No', they will not be eligible for support.
7. Select all applicable chronic diseases from the provided list that the patient has been diagnosed with.
8. Specify the required services by checking the relevant boxes for accommodations, transport, contributions, and any medical aids needed.
9. For specialist appointments, fill out the necessary details for each appointment, including name, address, phone number, and whether the appointment is booked.
10. Complete the Patient Consent section, where the patient confirms their understanding and consent to share information for care planning.
11. Ensure that both the patient and the health professional sign and date the consent form.
12. Once the form is complete, you may save changes, download, print, or share the referral as needed. Make sure to fax or email the completed form and consent page to the provided contacts.

Complete the Marrabinya Referral Form online to ensure that you access the necessary health services.