GP Referral

Let’s get it done

Colonoscopy and endoscopy delivered by an experienced team of doctors.

Our doctors are available to speak to you 24 hours 7 days per week, please call to be connected directly to one of our doctors. We are here to answer any of your questions and to help coordinate the care of your patients.

GP Referral

Please complete the following form.

Colonoscopy Clinic will contact your patient as soon as possible to make an appointment. Thank you for the referral.

07 3870 3799

Patient Details
Name*
Date of Birth
Phone / Mobile*
Patient Address
Address
Street Address Address Line 2 City State Post Code
Indication (please select all appropriate)*
- Diagnosis (symptoms, +iFOBT, iron deficiency etc)
- Follow up (past polyps, cancer, inflammation etc)
- Screening or family history
- Other (please describe below):
Other
Procedure Details
Preferred Specialist
Referring Doctors Details
Practice Name*
Referring Doctor Name*
Referring Doctor Provider Number*
Referring Doctor Email*
Referring Doctor Phone*
Date*
DD slash MM slash YYYY
Referring Doctors Address
Referring Doctor Address
Street Address Address Line 2 City State Post Code
Your patient will receive a preliminary report on the day of their procedure, and the pathology will be sent directly to you. Our doctors will then review the pathology and update their recommendations in a final report that will be sent to you and your patient within 2 weeks of the procedure. Thank you for your referral.
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Email
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Early detection saves lives

Colonoscopy and endoscopy – it could be the most important thing you do this year. Let’s get it done.

Learn more

GP Referral

Let’s get it done

Colonoscopy and endoscopy delivered by an experienced team of doctors.

GP Referral

Please complete the following form.

Colonoscopy Clinic will contact your patient as soon as possible to make an appointment. Thank you for the referral.

07 3870 3799

Patient Details

Patient Address

Referring Doctors Details

Referring Doctors Address

Early detection saves lives

Colonoscopy and endoscopy – it could be the most important thing you do this year. Let’s get it done.