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Complex or undifferentiated medical problems

Minimum referral criteria

Category 1 - Seen within 30 days

  • Unstable co‑morbidities which require early medical intervention (to prevent further deterioration that may result in emergency hospitalisation)
  • Recent discharge from hospital or emergency department (< 4 weeks), and need for ongoing surveillance and optimisation of co‑morbidities
  • Acute exacerbation of a chronic medical condition which impacts on other co‑morbidities, and requires close monitoring
  • Rapidly progressive or recent onset of undifferentiated syndromes for which definitive diagnosis or management plan is required e.g:
    • pyrexia (T< 39°C) of unknown origin
    • marked decline in cognitive function
    • generalised sub-acute myalgia or arthralgia, or other undifferentiated rheumatic syndromes
    • generalised lymphadenopathy
  • Fatigue lasting > 3 months and any of the following:
    • significant weight loss (≥ 5% body weight in previous 6 months)
    • recent or progressive onset in previously well, older patient
    • dyspnoea or other features suggestive of cardiorespiratory compromise
    • unexplained lymphadenopathy
    • presence of fever

Category 2 - Seen within 90 days

  • Stable co‑morbidities that require risk assessment and medical optimisation
  • Stable or slowly progressive undifferentiated syndromes (e.g., fatigue, decline in cognitive function, generalised lymphadenopathy), for which definitive diagnosis or management plan is required.
  • Chronic symptoms (e.g., dyspnoea, dizziness, imbalance), or condition requiring investigations and management to minimise long term impairment
  • Chronic symptoms causing significant social, economic, or functional impairment
  • Diagnostic dilemmas requiring further investigation or confirmation
  • Connective tissue disease which is active, but not life threatening
  • Polymyalgia rheumatica (PMR)

Category 3 - Seen within 365 days

  • Multiple co‑morbidities in need of regular review where referral to two or more specialty clinics imposes an unacceptable burden on patients
  • Soft tissue rheumatism
  • Non‑progressive fatigue lasting > 3 months that remains unexplained despite detailed investigation

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 Ask the patient their ethnicity

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)

Essential information

  • Relevant medical history, co-morbidities (including depression and anxiety), and medications (including an assessment of adherence)
  • Details of all treatments offered and assessment of efficacy
  • A clear indication of clinical question that the specialist is required to address
  • Details of any functional decline or cognitive impairment
  • FBC, E/LFT, ESR, and TSH results
  • In cases of suspected malignancy, pyrexia of unknown origin, or generalised lymphadenopathy, also include:
    • CT scan chest, abdomen and pelvis
    • Anti‑nuclear antibodies (ANA), plus full antibody profile if ANA > 1/640
    • Serum protein electrophoresis
  • In cases of myalgia or arthralgia, also include:
    • Creatine phosphokinase test (CPK) results
    • ANA plus full antibody profile if ANA > 1/640
  • In cases of poorly controlled diabetes, also include:
    • HbA1c
  • In cases of suspected rheumatological or systemic inflammatory conditions, also include:
    • CRP, Rh factor, and ANA results
  • In cases of suspected or known cardiorespiratory disease, also include:
    • Chest X‑ray
  • In cases of unexplained fatigue of recent onset, also include:
    • Impact on daily life and work (including falling asleep while driving)
    • Chest X‑ray
    • Urinalysis results
    • Calcium, ESR and CRP, iron studies, CPK (if muscle weakness or pain), vitamin B12, and folate results

Additional information

  • Existing psychosocial issues and supports
  • Copies of discharge summaries and outpatient letters relating to encounters with other specialists
  • ECG
  • Brain natriuretic peptide (BNP) (if available)
  • Magnesium and phosphate results (if appropriate)
  • Documentation relating to past hospitalisations and clinic visits for anxiety or depression (if appropriate)
  • Background information on occupational history and past infectious diseases (if appropriate)

Information for your patient

Expected time frame for appointment notifications

  • Once the request is received, categorisation by the hospital will occur.
  • General practitioners and patients are notified of the assigned category between 14 days to 1 month after completed request is received.
  • Patients are usually notified of the upcoming appointment time and date approximately 4 weeks prior unless short notice appointments become available.

Appointment information

  • Patients will be given an appointment via phone, SMS, or letter.
  • The patient must contact the hospital to reschedule if they are not able to attend.
  • If the patient fails to respond to 2 appointment offers:
    • They will be discharged back to their general practitioner.
    • They can have a new request for assessment sent to the hospital if the need still exists.
  • The patient's first appointment may not always be with a specialist. Where appropriate, the request may be sent to a public allied health or nursing service for initial assessment and management. A specialist assessment may then be arranged or ruled out.

Ask your patient to:

  • take a list of current medications, and all relevant radiology films and reports to appointments.
  • advise of any change in circumstance (e.g., getting worse or becoming pregnant), as this may affect the request for assessment.
  • update their contact details (e.g., phone number and address) with the hospital.
Last updated: 24 January 2020

Send referral

Specialist Outpatient Department

Fax: 1300 017 155

CQ Fracture/urgent referrals
Fax: (07) 4920 7242

Named referrals

If you would like to send a named referral, please address it to a specialist listed below.


  • Dr Shiromali Malalasekera
  • Dr Roshini Cherian
  • Dr Nooralddin Al-Saffi
  • Dr Aye Su Mon


  • Dr Basim Nona
  • Dr Darren Bowles

> view all CQ Health specialists

Service advice

Phone: (07) 4920 6440

Phone: (07) 4976 3200
Phone: (07) 4976 3186


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