Podiatry

Podiatry eReferral

Patient Details
If contact details are incorrectly input where mandatory the referral cannot be processed
Patient has consented to information sharing?*
Optional Attachment
Referrer Details
If contact details are incorrectly input where mandatory the referral cannot be processed
Referral
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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.