Referral forms
GPs and private health care providers
Please enter your details below to access the Queensland Children’s Hospital specialist referral form. By registering your details, you will receive an email notification each time this form is updated. This will ensure all referrals are addressed to the correct specialist, avoid unnecessary delays in processing and minimise requests for changes to referrals. The eligibility requirements should be reviewed before referring your patient.
Please consult the Child Health Service pre-referral guidelines before submitting a referral and use the Child Health Service referral form.
Queensland Health or Government clinicians
Please email completed referral form to DeadlyEars@health.qld.gov.au
External clinicians
Please fax completed referral form to 07 3310 7810
- CYMHS Referral form
- CYMHS Referral Guidelines
Please use this referral form if you are referring to one of the following CYMHS services:
- Inala Community Clinic
- Mt Gravatt Community Clinic
- North West (Keperra) Community Clinic
- Nundah Community Clinic
- Pine Rivers Community Clinic
- Yeronga Community Clinic
- Eating Disorders Program (excl. Day Program)
- Zero to Four
- CYMHS Eating Disorders Program Referral – Queensland Health Staff Use Only
Please use this referral form if you are referring to the Eating Disorders Statewide Program or referring internally from within Children’s Health Queensland.
If you are external to Queensland Health and wish to refer to the Eating Disorders Program, please use the CYMHS Referral form.
- CYMHS Eating Disorders Program Referral – Specialist Day Program
Please use this referral form if you are referring to the Eating Disorders Day Program.
Day Program Referral Guidelines
