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Please fill in the form below and it will be submitted to JCUHealth Reception, your requested health clinic will then review your referral and contact the client directly to discuss appointment options.

If you would like to download a referral form click here.

Online Referral Form

(If more than one please complete and submit seperate referral forms)

Client Contact Details


(including parent/guardian where applicable)
(e.g. Doctor, Allied Health Clinician, Community Health Carer, Teacher, Relative)
(e.g. Practice, Health Centre, School)
Terms & Conditions - Personal information A secure environment is in place when personal information is collected to ensure that it cannot be accessed by other users or organisations. This applies to this online referral form within our website.

Alternatively below are PDF forms. Please download, print and fill in the referral information.

Completed forms are to be emailed to JCUHealth [email protected] or faxed to  4779 2739.


Please Note: No referral required for the GP/Doctor clinic or Physiotherapy clinic.

Appointments for these clinics can be made directly through JCUHealth Reception (07) 4781 4495