Diabetes Specialist Nurse - SOUTH ONLY

Diabetes eReferral

If contact details are incorrectly input where mandatory the referral cannot be processed
Patient consented to information sharing?*
To be seen in -
Overseas visitor?
Type (Tick as appropriate)
Type of Referral
If you do not receive an email acknowledgement your referral has not been submitted. Please check that all details are correct, mandatory fields completed and re-submit.