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Home
About
- Work with us
Services
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Patient Info Hub
Refer a Patient
Contact Us

Refer a patient

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Home
About
- Work with us
Services
Locations
Our Team
Insights
Patient Info Hub
Refer a Patient
Contact Us

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Home
About
- Work with us
Services
Locations
Our Team
Insights
Patient Info Hub
Refer a Patient
Contact Us

Dr Dorota Long

Dr Chloe West

Simple referrals and easy access to specialist care

Referring a patient is simple and secure. Our team ensures a smooth process from referral to appointment.

Refer a patient

Referring a patient is simple and secure. Our team ensures a smooth process from referral to appointment.

Patient's Full Name *

Referrer's Full Name *

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Type of Referral: *Urgent ReferralRoutine ReferralPFT Only

Patient Details

Patients Full Name *

Contact Number *

Date of Birth *

Medicare Number

Sex at Birth *MaleFemale

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Requested Investigations

Please select an option *Complex lung function assessment [Spirometry (pre and post), Lung Volumes, DLCO (Hb cor)]Spirometry (pre and post)Six minute walk test

Relevant Clinical Details (including bronchodilator therapy):

Please specify any relevant clinical details *

Referring MO Details:

Provider number *

Extra copies to

Digital Signature *

Date *

Please upload referral letter: *Please Note: Referral Letter must be signed.

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Contact Us

Ready to take the next step in your care? Fill out the form below to request a consultation, and our team wil be in touch.

Full Name *

Phone *

Email *

Comment *

Please do not fill in this field.

South Australian Medical Specialists is a group of specialist doctors providing coordinated, patient-focused care across Adelaide and South Australia.

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Contact:
Phone: 08 8298 9025
Email: admin@samedicalspecialists.com.au

Address:
379 Brighton Road,
Hove SA 5048.

Business Hours:
Monday – Friday
08:30am – 05:00pm
Closed Saturday & Sunday

South Austrailian Medical Specialists Pty Ltd | AB 86 483 590 578 and ACN 147 589 578

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Phone: 08 8298 9025
Email: admin@samedicalspecialists.com.au

We welcome feedback and are continually working to improve accessibility across our services.