instagram
Toggle navigation
Home
Our Team
Our Team
Media
Procedures
Skin
Skin Surgery Info
Skin Cancer
Scar Revisions
Moles & Cysts
Hand
Hand Surgery Info
Hand Injuries & Tendinitis
Dupuytren’s Contracture
Cubital Tunnel Syndrome
Carpal Tunnel
Osteoarthritis
Hand Therapy
Face
Facial Surgery Info
Brow Lift
Eyelid Surgery
Ear Surgery
Post Baby
Post Baby
Makeover Breast Surgery
Makeover Tummy Tucks
Breast
Breast Surgery Info
Breast Augmentation
Breast Reduction
Breast Lift
Breast Reconstruction
Breast Asymmetry
Breast Implant Revision
Nipple Surgery
Male Breast Surgery
Body
Body Surgery Info
Abdominoplasty
Liposuction
Labioplasty
Resources
Patient Resources
Doctor Login
FAQs
Blog
Referrals
Contact Us
Skin Lesion Referral Form
Name:
First Name:
Last Name:
Date of Birth:
Patient Contact Number:
This referral is valid for:
12 months
Indefinite
Preferred Location:
Everton Park
Sunnybank
Urgency:
Urgent (within 10 days)
Semi-Urgent (within 4 weeks)
Prompt Attention (within 8 weeks)
Non urgent
Appointment:
Patient will call for an appointment
Please call patient with an appointment
An appointment has already been arranged
Please call next of kin with an appointment
Next of Kin Contact Number:
Clinical Referral:
Specific Lesions.... And /Or
Multiple skin lesions to be assessed and treated as required
Site & Size:
Has it been Biopsied:
Yes
No
Attachments:
Additional notes, Past Medical History, Medication List, Relevant Pathology/ Imaging Results
Referrer's Name:
First Name:
Last Name:
Email for confirmation of receipt:
Referrer Contact Number:
Provider number:
Date of Referral:
Spam Verification:
Please tick to verify that you are not a robot
Latest Blog
Read More
Breast Implants, Breast Cancer and Screening
Posted by Dr Lily Vrtik on 1 August 2019
There are controversial and contradictory information about breast implants, breast cancer and breast c...
Continue reading
Posted in:
plastic surgery
Breast implants
Breast
Subscribe via RSS
Tweet
TGA Suspension of Textured Implants
Posted by Dr Lily Vrtik on 11 July 2019
Today (11th July), TGA (Therapeutic Goods Administration) has proposed regulatory actions to susped or cancel text...
Continue reading
Posted in:
Breast implants
Breast
Subscribe via RSS
Tweet
Types of Breast Implants - How do I pick?
Posted by Dr Lily Vrtik on 1 June 2019
There are different type of breast implants. Implants can be classified by several characteristics: Implant...
Continue reading
Posted in:
plastic surgery
Breast implants
Breast
Subscribe via RSS
Tweet
What is a BCC (Basal Cell Carcinoma)?
Posted on 1 April 2019
BCCs are abnormal, uncontrolled growths or lesions that arise in the skin's basal cells, which line...
Continue reading
Posted in:
plastic surgery
Skin Cancers
Skin
Subscribe via RSS
Tweet
< Previous
|
1
|
2
|
3
|
4
|
5
|
Next >
instagram
 "Breast Implants, Breast Cancer and Screening")
 "Types of Breast Implants - How do I pick?")
 "What is a BCC (Basal Cell Carcinoma)?")
