Welcome to Midwest GP Network |

05 September 2010 | |

Midwest GP Network | 32 Holland Street GERALDTON WA 6530 | PO Box 2638 GERALDTON WA 6531
Tel (08) 9920 7100 | Fax (08) 9964 3487 | mail@gpnetwork.org.au

Topics

The available templates are under the following sections:

  • Administration
  • Carers
  • Geriatric
  • MBS items
  • Medicines
  • Mental Health
Administration
MGPN Membership Application Form

To become a member of the Midwest GP Network, Complete this form and fax it to the Midwest GP Network.

   

Created: 10 May 2010
Locum Request

Application to request regional locum, to complete and return to Midwest GP Network.

   

Created: 10 May 2010
Carers
Midwest Carer Respite Referral

 This form is available either in PDF form or as a MD/BP template.

Do not open the template before importing into your medical software.

   

Created: 10 May 2010
Needs Assessment

This is a MD/BP template. Do not open it before importing into your medical software.

   

Created: 10 May 2010
Geriatric
WACHS Occupational Therapy Outpatient

This form is available in PDF format to fax or as a template for MD/BP.

Do not open the template before importing in your medical software.

   

Created: 03 June 2010
ACAT Referral

Aged Care Assessment : This form is available in fax format (.doc) or in Md/BP template (.rtf).

Do not open the template before importing into MD/BP.

   

Created: 10 May 2010
WACHS Geriatrician consultation request

 This form is available either as a fax format (doc) and as a MD/BP template.

Do not open the template before importing into MD/BP

   

Created: 10 May 2010
MBS items
Lifestyle Modification Program

GP referral to a Lifestyle Modification Program under the prevention of type 2 diabetes program. This form is available in fax format (pdf document) or in MD3 Template

Do not open the MD3 template before importing.

   

Created: 11 May 2010
Referral form for Allied Health Group Services

 Referral form for Allied Health Group Services under Medicare for patients with type 2 diabetes.

MD3 template - Do not open before importing.

   

Created: 11 May 2010
45 Year Old Heath Check

MBS item 717.

template to import into MD/BP. (Do not open this file before importing.)

   

Created: 10 May 2010
GP Management Plan

MBS Item 725

Template to import into MD/BP. (Do not open it before importing.)

   

Created: 10 May 2010
Combined GP Management Plan & Team Care Arrangement

MBS items 721 and 723

When downloading the template (.rtf), do not open the file before importing into your Medical software (MD/BP).

   

Created: 10 May 2010
Team Care Arrangement

TCA only - MBS Item 723

This is a MD/BP template. Do not open it before importing.

   

Created: 10 May 2010
Medicines
Opioid Medicine Treatment Contract

Treatment contract for the use of opioid medicine (morphine-like painkiller) for the management of chronic pain.

MD/BP template - do not open before importing.

   

Created: 11 May 2010
HMR Referral

Referral to send to Pharmacists. Templates to import in your medical software (rtf is for MD/BP, mtd is for MedTech).

   

Created: 10 May 2010
Medication Management Plan

This plan exist as a PDF form or as a template to import in your medical software (rtf for MD/BP, mtd for MedTech 32).

Please do not open it before importing into MD/BP.

   

Created: 07 April 2010
Mental Health
MGPN Mental Health Referral form

The Mental Health Referral form is available either in fax format (.doc) or in MD/BP template (.rtf).

When downloading the template (.rtf), do not open the file before importing into your Medical software.

   

Created: 10 May 2010
K10 form

Mental Health assessment form.

   

Created: 10 May 2010
Edinburgh post natal depression scale

Mental Health assessment form

   

Created: 10 May 2010
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