Follow the steps to successfully complete your outpatient referral form

1. Click 'Get Form' button to obtain the form and open it in your document editor.
2. Begin by affixing the patient ID label in the designated area. This is essential for hospital use.
3. Select the relevant clinic or specialty for your referral by checking the appropriate box next to options such as Antenatal/Gynaecology or Cardiology.
4. Provide the patient's name in the designated field, ensuring it matches their identification documents.
5. Enter the patient's address clearly, including street, city, state, and zip code.
6. Include the patient's phone number, ensuring it is correct to facilitate communication.
7. Input the patient's date of birth in the required format to confirm their identity.
8. Detail any clinical information pertinent to the referral in the provided space, being as thorough as possible.
9. Indicate the referral length by checking the appropriate duration option: 3 months, 6 months, 12 months, or ongoing.
10. Enter the requesting doctor's name and details, including their provider number and contact information.
11. If the referral is urgent, note this clearly or follow up by calling the Outpatient Department as advised.
12. Once all fields are complete, save your changes. You may download, print, or share the form as required.

Take action now and complete your Campbelltown Outpatients form online.