Residential Aged Care Facilities

Residential Aged Care Facility Referrals
To refer a resident please send us an email containing the following information, or print off the
referral form below and fax or email it through to us:

1. The resident’s name and date of birth
2. State if the referral is “urgent” (within 2 business days) or “non-urgent” (within one week)
3. Reason for referral (e.g., Resident is having difficulty chewing meat, pocketing, and coughing with thin fluids)
4. Person referring (e.g., nurse, resident, resident’s family member, GP)
5. Relevant medical history (e.g., L CVA, Dementia, Cancer, Food allergies, Parkinson’s Disease)
6. The resident’s current diet and fluid consistency and how they take their medications (e.g.,
7. Soft and Bite-Sized, Thin fluids, Crushed medications)
8. The referrers name, position, contact number and date