Radiation
Services
GenesisCare offers:
- radiation therapy for cancer
- Deep inspiration breath hold (DIBH)
Visit the GenesisCare website for more information.
Information for referrals
Include the standard information (below).
Standard information for all referrals
Reason for request
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for general practitioner or second opinion
- For a specified test or investigation the general practitioner can't order, or the patient can't afford or access
- Reassurance for the patient or family
- For other reason (e.g., rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Patient's demographic details
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Phone contact numbers – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and Torres Strait Islander
Referring practitioner details
- Full name
- Full address
- Contact details – phone, fax, email
- Provider number
- Date of referral
- Signature
- Patient's usual general practitioner (if different from above)
Relevant clinical information about the condition
- Inclusion of Clinical Prioritisation Criteria (CPC) where relevant
- Presenting symptoms (evolution and duration)
- Physical findings
- Investigations carried out and results as indicated in the relevant pathway
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Options already pursued
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
Clinical modifiers
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and Torres Strait Islander
Other relevant information
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g., DVA, WorkCover, motor vehicle insurance)
Last updated: 24 January 2020
