This page provides a directory of templates that can also be found on the Resources Page or some Division Services pages.

MS Word versions of the generic and disease specific templates are available below for those who wish to view the templates before installing them or converting them to other software.

DO NOT OPEN THE ELECTRONIC TEMPLATES, AS OPENING THE TEMPLATE FILES MAY DESTROY THE TEMPLATE FIELDS WITHIN THEM, PLEASE DOWNLOAD AND FOLLOW THE INSTRUCTIONS BELOW.

Templates should be saved to your computer and then imported into Medical Director as per the instructions below.

Paper Based Versions of Templates

To quickly find an electronic template relating to a specific disease state please select a category below. Please select from drop down list Asthma 45 - 49 Health Check Centrelink Medical Certificate Chicken Pox Natural Immunity Childhood Disability Coronary Heart Disease Depression & Anxiety Diabetes Prevention Diabetes GP Management Plans & Team Care Arrangements HPV Vaccine Invitation Letter Home Medicines Review Healthy Kids Check Healthy Lifestyles Intellectual Disability Lifescripts Mental Health Osteoarthritis Osteoporosis Palliative Care Royal Children's Hospital Referral Southern Health Outpatients Referral Form Victorian Statewide Referral

Some Paper Based Versions may be in PDF format.

Electronic Templates

Instructions for importing document templates

• Instructions for Importing and Using Templates in Medical Director(7KB pdf)
• Instructions for importing document templates into Medical Spectrum (Classic)

45 - 49 Health Check

• 45 - 49 Health Check Template for Medical Director (please see above for instructions on how to download template)

Australian & Torres Strait Islander Checks

• Aborigional Health for Life Template for Medical Director and Resources (Link to External Webiste)
• Older Persons Health Check Proforma
• Child Health Check Proforma

Centrelink Medical Certificate (for Medical Director)

• Centrelink Medical Certificate  - please refer to the instructions for importing templates before proceeding

Diabetes Prevention

• Australian Type 2 Diabetes Risk Assessment Tool (please see above for instructions on how to download template)
• Type 2 Diabetes Risk Evaluation (Medicare item 713) (please see above for instructions on how to download template)
• Lifestyle Modification Program – referral form (please see above for instructions on how to download template)

GP Management Plans and Team Care Arrangements (please see above for instructions on how to download template)
(please note that these templates can be used in MD2 and MD3)

• GP Management Plan (Item 721)
• GP Management Plan with prompts
• Team Care Arrangement (Item 723)
• Team Care Arrangements cover letter
• Team Care Arrangements with prompts

Asthma (please see above for instructions on how to download template)

• Asthma GP Management Plan
• Asthma Team Care Arrangements

Childhood Disability (please see above for instructions on how to download template)

• Childhood Disability GP Management Plan

Coronary Heart Disease (please see above for instructions on how to download template)

• Coronary Heart Disease GP Management Plan
• Coronary Heart Disease Team Care Arrangements

Depression- Anxiety (please see above for instructions on how to download template)

• Depression-Anxiety GP Management Plan
• Depression-Anxiety Team Care Arrangements

Diabetes (please see above for instructions on how to download template)

• Diabetes GP Management Plan
• Diabetes Team Care Arrangements

Osteoarthritis (please see above for instructions on how to download template)

• Osteoarthritis GP Management Plan
• Osteoarthritis Team Care Arrangements

Osteoporosis (please see above for instructions on how to download template)

• Osteoporosis GP Management Plan
• Osteoporosis Information Sheet
• Osteoporosis Team Care Arrangements

Palliative Care (please see above for instructions on how to download template)

• Palliative Care GP Management Plan

Please note:
The above templates for the new MBS items , GP Management Plan and Team Care Arrangements, have been developed from the draft forms on the DoHA website. It is not mandatory to use these forms, they are samples for assisting GPs and others in completing the services and can be customised to meet the need of patients and practitioners in your practice. Templates for the Allied Health and Dental Care EPC referrals are available under the "Supplied" templates in Medical Director.

Healthy Kids Check

• Health Kids Check Template for Medical Director (please see above for instructions on how to download template)

Healthy Lifestyles

• Go for your life GP referral (please see above for instructions on how to download template)

Home Medicines Review (please see above for instructions on how to download template)

• HMR Referral Template for Medical Spectrum (Classic) (68KB dot)
• HMR Plan Template for Medical Spectrum (Classic) (36KB dot)
• HMR Referral Template for Medical Spectrum (Plexus) (68 doc)
• HMR Plan Template for Medical Spectrum (Plexus) (35 doc)
• Using HMR Templates (552KB pdf)

HPV - new cervical cancer vaccine

• Invitation letter template for girls 18-26 (please see above for instructions on how to download template)

A Paperbased version template is also available.

Immunisation Natural Immunity to Chicken Pox Report

• Report a Childs Natural Immunity to Chicken Pox to ACIR (please see above for instructions on how to download template)

Intellectual Disability

• Health Assessment (please see above for instructions on how to download template)

Lifescripts for Medical Director

Alcohol (please see above for instructions on how to download template)

• Alcohol Assessment
• Alcohol Guidelines
• Alcohol Prescription

Nutrition (please see above for instructions on how to download template)

• Nutrition assessment
• Nurition Guidelines
• Nutrition Prescription

Physical Activity (please see above for instructions on how to download template)

• Physical Activity Assessment
• Physical Activity Guidelines
• Physical Activity Prescription

Smoking Cessation (please see above for instructions on how to download template)

• Smoking Assessment
• Smoking Guidelines
• Smoking Prescription

Weight Management (please see above for instructions on how to download template)

• Weight Management Assessment
• Weight Management Guidelines
• Weight Management Prescription

Mental Health

• Instructions for importing MD Templates
• Template for GP Mental Health Care Plan 2710- 12 (please see above for instructions on how to download template)
• GP to psychiatrist referral template (291)(21kb rtf) (please see above for instructions on how to download template)
• Better Access Referral Cover Sheet (please see above for instructions on how to download template)

Royal Children's Hospital

The Royal Children's Hosptial outpatient department have provided us with their referral template for Medical Director which was created by the North East Valley Divison of General Practice.

• Royal Children's Hospital Outpatient Referral FormVersion August 2006 please refer to the instructions for importing templates before proceeding

Southern Health Outpatient Referral Form for GPs

This template is for use when referring to any Outpatient Clinic across Southern Health.

• Southern Health l Outpatient Referral Form Version October 2007 - please refer to the instructions for importing templates before proceeding

Victorian Statewide Referrral

This template is the latest and shorter version of the templae used to refer patients to Community Health Centres, Local Government and other community based agencies.

• Victorian Statewide Referral Form (SCoTT) Version 4 January 2006 please refer to the instructions for importing templates before proceeding

Paper Based Version of the Templates

Aborigional & Torres Strait Islander

• Paperbased version of Child Health Check Proforma

Care Planning and Health Assessment

Please see above for instructions on how to download templates

• Asthma GP Management Plan
• Asthma Team Care Arrangements
• Childhood Disability GP Management Plan
• Coronary Heart Disease GP Management Plan
• Coronary Heart Disease Team Care Arrangements
• Depression-Anxiety GP Management Plan
• Depression-Anxiety Team Care Arrangements
• Diabetes GP Management Plan
• Diabetes Team Care Arrangements
• GP Management Plan (MBS Item 721)
• GP Management Plan with prompts
• Mental Health Care Plan
• Osteoarthritis GP Management Plan
• Osteoarthritis Team Care Arrangements
• Palliative Care GP Management Plan
• Team Care Arrangements Cover Letter
• Team Care Arrangements (MBS Item 723)
• Team Care Arrangements with prompts

Healthy Kids Check

• Paperbased version of Health Kids Check Template

Healthy Lifestyle

• Paperbased version of Go for your life referral

HPV Invitation letter for Gardasil Vaccine

• Invitation letter template for girls 18-26 (please see above for instructions on how to download template)

Intellectual Disability

• Paperbased version of Intellectual Disability Health Check

Mental Health

• GP to psychiatrist referral template (291) (please see above for instructions on how to download template)

Southern Health Outpatient Referral Form for GPs

This template is for use when referring to any Outpatient Clinic across Southern Health.

• Southern Health Paper Based Outpatient Referral Form Version October 2007 (please see above for instructions on how to download template)