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For Referrers

For Referrers

How to refer

Referrals can be submitted via the online form below, Medical Objects, fax, or email.

Fax: 07 3255 0322
Email: reception@uromed.com.au

Download Referral Form

Referral Form

Patient Information
Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone Number*
Email Address
Medicare Number*
Referring GP Information
Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone Number*
Provider Number*
Clinical Summmary*
Date
DD slash MM slash YYYY

Personalised treatment plan tailored to your needs

Book an appointment to discuss your symptoms, treatment options and ongoing care.

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Contact

Phone: 07 3255 0311

Fax: 07 3255 0322

Email: reception@uromed.com.au

Open Hours:
Monday – Friday 8:30 am – 4:30 pm

Address

Level 4, Suite 4.05 Mater Private Clinic, 550 Stanley Street, South Brisbane, QLD, 4101

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