REFERRAL FORMS

Whether you’re a GP, health practitioner, service provider or community member, this suite of referral forms will help you to access our allied health services and funded health programs.

Please note that some programs require the referral to be completed by a GP or other health professional. Please get in touch with our administration team should you require further information.

phone 98422797

If using the online fillable form option, please save the form as a pdf and email your referral form as an attachment to query@amityhealth.com.au

Allied Health Fee for service - GP and self-referral options:

Funded Programs (no cost to eligible clients):


If you are living in Denmark and surrounds, whether you’re a GP, health practitioner, service provider or community member, this suite of referral forms will help you to access our allied health services and funded health programs.

Please note that some programs require the referral to be completed by a GP or other health professional. Please get in touch with our administration team should you require further information.

phone 98422797

If using the online fillable form option, please save the form as a pdf and email your referral form as an attachment to query@amityhealth.com.au

Allied Health Fee for service - GP and self-referral options:

Funded Programs (no cost to eligible clients):


If you are living in Esperance or surrounds, and have been diagnosed with a chronic condition, it’s worth getting in touch with us, or talk to your GP as you may be eligible for our fully funded Integrated Chronic Disease Care program.

Our Care Coordinator, Exercise Trainer, Diabetes Educator and visiting Dietitian are located in our Esperance office and can provide support and rehabilitation to those who are at risk of, or live with, diabetes, cardiovascular disease, respiratory disease or obesity.

The program does require a referral from a GP or other allied health practitioners, along with a GP Management Plan.

phone 9842 2797

If using the online fillable form option, please save the form as a pdf and email your referral form as an attachment to query@amityhealth.com.au

Funded Program (no cost to eligible clients):


If you’re a GP, health practitioner, service provider or community member, based in Katanning or surrounding areas in the Central Great Southern region, there are several funded health programs available to eligible clients.

Please note that some programs require the referral to be completed by a GP or other health professional. Please get in touch with our administration team should you require further information.

phone 9842 2797

If using the online fillable form option, please save the form as a pdf and email your referral form as an attachment to query@amityhealth.com.au

Funded Programs (no cost to eligible clients):


Whether you’re a GP, health practitioner, service provider or community member, based in Merredin or the surrounding Eastern Wheatbelt, there are several funded health programs available to eligible clients, depending on location.

Please note that some programs require the referral to be completed by a GP or other health professional. Please get in touch with our administration team should you require further information.

phone 9842 2797

If using the online fillable form option, please save the form as a pdf and email your referral form as an attachment to query@amityhealth.com.au

Funded Programs (no cost to eligible clients):


Whether you’re a GP, health practitioner, service provider or community member based in Moora or the surrounding Coastal Wheatbelt, we provide funded programs in aged care, chronic disease, mental health and Aboriginal health, to eligible clients, depending on location.

Please note that some programs require the referral to be completed by a GP or other health professional. Please get in touch with our administration team should you require further information.

phone 9842 2797

If using the online fillable form option, please save the form as a pdf and email your referral form as an attachment to query@amityhealth.com.au

Funded Programs (no cost to eligible clients):


Whether you’re a GP, health practitioner, service provider or community member based in Narrogin or the surrounding Southern Wheatbelt, we provide funded programs in chronic disease, mental health and Aboriginal health, to eligible clients, depending on location.

Please note that some programs require the referral to be completed by a GP or other health professional. Please get in touch with our administration team should you require further information.

phone 9842 2797

If using the online fillable form option, please save the form as a pdf and email your referral form as an attachment to query@amityhealth.com.au

Funded Programs (no cost to eligible clients):


Whether you’re a GP, health practitioner, service provider or community member based in Northam or the surrounding Central Wheatbelt, we provide funded programs in aged care and mental health to eligible clients, depending on location.

Please note that some programs require the referral to be completed by a GP or other health professional. Please get in touch with our administration team should you require further information.

phone 9842 2797

If using the online fillable form option, please save the form as a pdf and email your referral form as an attachment to query@amityhealth.com.au

Funded Programs (no cost to eligible clients):


In the Midwest and South West regions of WA, we provide mental health counselling to various Residential Aged Care Facilities (RACFs)

In the Midwest we provide mental health counselling to various RACF’s in Geraldton, while in the South West, counselling is available to RACF residents in Bridgetown, Bunbury, Busselton, Collie, Donnybrook, Dunsborough, Harvey, Manjimup and Margaret River.

If you are a GP or work in Residential Aged Care you can refer patients who have mild to moderate mental health challenges, and who meet the eligibility criteria. Please get in touch with our administration team should you require further information.

phone 9842 2797

If using the online fillable form option, please save the form as a pdf and email your referral form as an attachment to query@amityhealth.com.au

Funded Program (no cost to eligible clients):