Referral Form for Chronic Disease Allied Health (Individual) Services under Medicare issued by the Department

This page contains a referral form that is a resource for GPs to meet their regulatory requirements when referring a patient for Medicare rebateable allied health services under the Chronic Disease Management (CDM) Medicare items.

Page last updated: 26 April 2018

If you have any difficulty accessing the documents on this page, please email mbd.web@health.gov.au

GPs can use this form or a referral form that contains all the components of the form issued by the Department.

Referral Form for Allied Health Services under Medicare (PDF 50 KB)
Referral Form for Allied Health Services under Medicare (Word 45 KB)