To find a specific template, press Ctrl+F and then type the keyword or topic you are looking for. If you don't find the topic the first time, try variations, different terms or fewer words. The templates provided by us are for your personal use only and must not be redistributed without permission. They have been tested with Version 1.8.4.642 of Best Practice and Version MD3.16 of Medical Director.

Many templates are available under the 'Supplied' section of most clinical software or searchable online from their respective organisations. If you have templates that you would like to share with your peers and/or have any enquiries please email the Practice Support and Digital Health team or phone them on 1300 986 991.

These templates have been specifically made to be important to your software or for use by printing out and handwriting in the form itself. The following documents can be downloaded to provide instructions on how to import these templates to your chosen program.

• Importing Templates into Best Practice from CESPHN Website
• Importing Templates into Medical Director from CESPHN Website

BP or MD templates should not be opened and viewed before downloading them into your practice software. An OPEN template, which is the MS-Word or PDF version of a template allows you to open and view the template before downloading it into your practice software. You can also use the Open version to complete assessments without going through the practice software.

The templates provided by CESPHN are for your personal use only and must not be redistributed without permission. They have been tested with the versions of Best Practice (1.8.4.642) and Medical Director (MD3.16).

All templates	Date as at	PDF	Word	Best Practice	Medical Director
List of all available templates by file type

Covid@Home	Date as at	PDF	Word	Best Practice	Medical Director
Covid@Home GP Referral form	26 April 2022
Instructions how to import, update address book and send electronically
Chronic Disease Management and Prevention	Date as at	PDF	Word	Best Practice	Medical Director
Accredited Exercise & Sports Science Practitioner - GP Referral Form			-	-	-
Accredited Practising Dietitian - GP Referral Form		-
Asthma - Action Plan template			-
Cancer - Breastscreen NSW Patient Referral Sheet
Cancer - Bowel Cancer Letter Template			-
COPD - Action Plan template (Lung Foundation)			-
Diabetes - AUSDRISK Tool			-
Diabetes - Basic Foot Assessment Checklist			-
Diabetes - NDSS Registration Form			-
40-49 year old Type 2 Diabetes Risk Evaluation			-
Optimised 75+ Health Assessment
Health Assessment - Refugee Health Assessment			-
Health Assessment - People with an Intellectual disability			-
Quitline - Referral Form			-
YMCA Brightside Referral - Morris Iemma ISC			-
Telehealth Staying Healthy, Living well - GP Referral Template	-		-
Think, Eat and Move (TEAM) Referral Form -13 to 17 year old
SLHD Podiatry Intake Form

Closing the Gap and Indigenous Health	Date as at	PDF	Word	Best Practice	Medical Director
Aboriginal Outreach Worker Referral Form			-	-	-
Allied Health Services Referral		-
CESPHN - Referral for Care Coordination			-	-	-
Closing the Gap Standard Specialist Referral		-
Closing the Gap Specialist Referral and Progress Notes		-
Health Assessment Adult 15-54 (MBS ITEM 715)		-		Supplied in BP	Supplied in MD
Indigenous Health Incentive and PBS Co-payment Patient Registration/Consent		-
Indigenous Health Incentive and PBS Co-payment Patient Withdrawal			-	-	-

General	Date as at	PDF	Word	Best Practice	Medical Director
Schedule 1 - Medical Certificate		-
National Centre Veterans Health Care Referral form	15 August 2019	-	-

GP Management Plan and TCA	Date as at	PDF	Word	Best Practice	Medical Director
Generic template - GPMP review		-

Hospital - Calvary Hospital	Date as at	PDF	Word	Best Practice	Medical Director
Community Palliative Care Team (CPCT) - Admission Form		-	document (105 KB)	document (140 KB)
Community Palliative Care Team (CPCT) - Referral Form		-		document (156 KB)

Hospital - Canterbury Hospital	Date as at	PDF	Word	Best Practice	Medical Director
Endocrine/Maternity Clinic Referral form			-
Obstetric Referral Form	2 August 2018		-	document (140 KB)	-
Refugee Health Nurse Program		-

Hospital - Prince of Wales Hospital (POWH)	Date as at	PDF	Word	Best Practice	Medical Director
Diabetes Centre Referral		-
Outpatient Department GP eReferral		-	-
High Level and Complex Diabetic Foot Care Referral
Prince of Wales Hospital – Eye Clinic, Assessment for Cataract surgery

Hospital - The Royal Hospital for Women (RHW)	Date as at	PDF	Word	Best Practice	Medical Director
Gynaecology Outpatients Referral		-
Perinatal Mental Health Referral form			-

Hospital - Royal Prince Alfred Hospital (RPA)	Date as at	PDF	Word	Best Practice	Medical Director
RPA- Pathology Form for Combined First Trimester Screening blood collection
RPA - Fibroscan Only (pre HVC treatment) referral form			-
RPA - Remote Consultation Request for Initiation of Hepatitis C Treatment	25 July 2016		-
RPA Physiotherapy - Obstetric and Gynaecological Physiotherapy Referral	25 July 2017
RPA Women and Babies - Antenatal Thyroid Referral Form	4 June 2021		-	-	-
RPA Women and Babies - EPAS Referral Form	20 March 2015		-
RPA Women and Babies - HBV Referral Form			-
RPA Women and Babies - HCV Referral Form			-
RPA Women and Babies - Psychosocial Referral Form			-
RPA Sexual Health GP Referral Form
RPA Women and Babies Ultrasound and Fetal Medicine Referral Form	August 2020
RPA Liver Tool Kit Referral Form	September 2021

Hospital - St George Hospital	Date as at	PDF	Word	Best Practice	Medical Director
St George Outpatient Department Referral
Clinical Genetic Service Referral
Diabetes Education Centres Referral Form (St George and Sutherland)			-
Fibroscan Only (pre HVC treatment) referral			-
Pulmonary Rehabilitation Program Entry Form			-
Remote Consultation Request for Initiation of Hepatitis C Treatment form			-
St George Swallow Centre - Request Oesophageal Function Studies		-
St George Hospital Gynaecology Clinics referral form
St George Hospital Liver Tool Kit Referral Form	September 2021
St George and Sutherland hospitals: High risk foot services

Hospital - St Vincent's Hospital	Date as at	PDF	Word	Best Practice	Medical Director
Chronic Pain Services Referral		-
Colonoscopy Referral Form (FOBT)

Hospital - The Sutherland Hospital	Date as at	PDF	Word	Best Practice	Medical Director
Outpatient GP Referral			-
Eye Clinic - GP Diabetic Retinopathy Screening Referral Form	5 July 2017	-
St George/Sutherland - Antenatal Referral & Booking Form			-		document (92 KB)
Sutherland Hospital Gynaecology Clinics referral form
Sutherland and St George hospitals: High risk foot services

Hospital - Sydney Eye Hospital	Date as at	PDF	Word	Best Practice	Medical Director
Sydney Eye Hospital – Outpatients, Assessment for Cataract Surgery

Local Health District - South Eastern Sydney Local Health District (SESLHD)	Date as at	PDF	Word	Best Practice	Medical Director
NSW Health - Out of Home Care Health Management Plan (NH606661)			-		document (92 KB)
NSW Health - Out of Home Care Primary Health Screen (2A) Under 1 yr (NH606662)			-		document (92 KB)
NSW Health - Out of Home Care Primary Health Screen (2A) 1-5 years (NH606663)			-		document (92 KB)
NSW Health - Out of Home Care Primary Health Screen (2A) 6-11 years (NH606664)			-		document (92 KB)
NSW Health - Out of Home Care Primary Health Screen (2A) 12-18 years (NH606665)			-		document (92 KB)
SESHLD - Connecting Care Referral Form Access and Referral Intake Form			-
St George/Sutherland - Antenatal Referral & Booking Form			-		document (92 KB)

Local Health District - Sydney Local Health District (SLHD)	Date as at	PDF	Word	Best Practice	Medical Director
Concord Hospital: Midwifery Group Practice GP Referral Form
SLHD - Aged Chronic Care and Rehabilitation Referral Form			-	-	-
SLHD - CHAIN Referral and Clinical Handover Form			-	-	-
SLHD - GP Incident Notification			-
SLHD - Pain Clinic Referral Form		-
SLHD - Palliative Care Home Support Packages (PEACH Program) Referral			-	-	-
SLHD - Podiatry Service Intake Form

Mental Health	Date as at	PDF	Word	Best Practice	Medical Director	Online
Mental health shared care checklist
PSS – GP Initial Referral for adults and children Mental Health Treatment Plan
PSS – GP Review Referral for adults and children and Mental Health Treatment Plan
Resources - Depression, Anxiety, and Stress Scales (DASS 21)
Resources - Health of the Nation Outcome Scale (HoNOS)	Refer online
Resources - Kessler Psychological Distress Scale (K10+)		-	-
Services Referral - Black Dog Insitute Referral Forms for Clinics	Download forms from hospital's website
Services Referral - headspace Ashfield		-		-	-
Services Referral - headspace Bankstown			-	-	-
Services Referral - headspace Bondi Junction			-	-	-
Services Referral - headspace Camperdown			-	-	-
Services Referral - headspace Hurstville		-
Services Referral - headspace Miranda			-	-	-

Pain Management	Date as at	PDF	Word	Best Practice	Medical Director
Inner West Pain Centre - Referral Form	Refer online
SLHD Pain Clinic - Referral Form		-

Sexual Health and Viral Hepatitis	Date as at	PDF	Word	Best Practice	Medical Director
HIV GPMP and TCA			-
Patient Consent Form - s100 Highly Specialised Drug Prescriptions			-
RPA - Fibroscan Only (pre HVC treatment) referral form			-
RPA - Remote Consultation Request for Initiation of Hepatitis C Treatment			-
St George Hospital - Fibroscan Only (pre HVC treatment) referral			-
St George Hospital - Remote Consultation Request for Initiation of Hepatitis C Treatment form			-
Liver Tool Kit Project Letter

NDIS	Date as at	PDF	Word	Best Practice	Medical Director
Supporting NDIS Access 7 - 65 years		-	-