GP-OBS Referral Form

Referral Form for Collaboration with Community Midwifery Services.

Note to obstetricians and GP obstetricians: Louise Paterson –Clinical Midwifery Specialist, works alongside obstetricians and GP obstetricians to provide complementary midwifery care from pregnancy throughout the postnatal period. For clients to receive medicare rebates for my antenatal and postnatal care, please fill in the form below and email, post or send back to me with the client.

Please provide referral to Louise Paterson –Community Midwifery Services –

12 Dawson Court, Aspendale Gardens, Victoria 3195

Clinical Director – Louise Paterson (4445112Y)

Tel: 0420559746

Client Name:

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Clinical Details:

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Reason for referral:

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Doctor Name:

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Signature of Doctor:

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Provider Number:

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Preferred contact details:

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Date:

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