.. Information to complement the GP consultation.

General Information

Travel Information

Division Information

Video index

(Developed by Dr Colin Adams)
.. or back to CDM factsheets

Hospital referral templates


Generic Plans

Other Templates below

Eligibility checklist .. copy
for DMP (Disease management plan) with TCA (Team care arrangement)

Other Medical Director Templates:
Right click on link and select Save Target As... (brief instructions to install)

Templates below (item 721) Generic TCA (723) brief fax/letter for careplan
( to be used when you have already created a DMP item 721 )
Chronic Kidney Disease Chronic Kidney Disease with TCA & ref
Diabetes DMP TCA- example Allied Health referral
Diabetes DMP update - example Allied health aged care
Heart-Hypertension-Lipids Careplan Dementia Careplan .. Testing for template
Over 75 part 1 - nurse worksheet template eg of worksheet pdf
Over 75 part 2 - final plan template eg of final sheet  pdf
NEPMHT Referral template (new 11/12) NEPMHT Referral form .. 1 page (pdf) updated 11/12

Fact sheets for patients on:      ..

  • Information about Health assessment over 75  (RACGP 2 page)
  • Information about careplans for patients - RACGP  (2 page)
  • Information about chronic disease management plans NEVDGP  (1page)
  • Information worksheet for patients having HMR  (NPS 2 page

Last modified:   November 14, 2012

Scoll Up Scoll Down

North East Valley Division General Practice, Victoria, Australia, Disclaimer 
Level 1, Pathology Building, Repatriation Campus, A&RMC, Heidelberg West VIC 3081. .. map
Phone: 03 9496 4333, Fax: 03 9496 4349,  Email: nevdgp@nevdgp.org.au
Please note: NEVDGP does not provide an on-line consultation

November 14, 2012