Patient Referral to NorthEast Plastic Surgery

At NorthEast Plastic Surgery, we accept referrals via mail, fax, email, argus and directly through our website using the options provided below. If you have any questions or need assistance, please don't hesitate to contact our team at (03) 9088 5000.

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Upload A Prewritten Referral

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Request Referral Pads By Post

UPLOAD A PREWRITTEN REFERRAL:

PATIENT ONLINE REFERRAL:

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Dr/Specialist Name *

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Last

Provider Number *

Practice Name *

Practice Email *

Practice Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

referral Patient Email

Practice Phone (include area code)

Patient Name *

First

Last

Date of Birth *

Address

Address Line 1

Address Line 2

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Postal Code

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Phone *

Email *

Reason for referral

Notes

Medications

optional - upload documents

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REQUEST REFERRAL PADS VIA POST:

of Practice code)

Dr/Specialist Name *

First

Last

Provider Number *

Practice name *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Practice Phone (include area code) *

Number of referral pads requested *

contact us

E: melbourne@northeastplasticsurgery.com.au
T: (03) 9088 5000
F (03) 9088 5001
P 0411865055
(paging service for after hours emergencies only)

Essendon practice
53 Fletcher Street
Essendon
Vic 3040

Onsite parking and tram service (59) to the premises

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St Vincents Private Hospital Consulting Suites
5 Studley Avenue,
Kew
Vic 3101

Onsite parking to the premises

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