Select your appointment type in the form below (RACF Call-Out, Telehealth or Community Visit). Provide or attach patient information and ensure the Patient, Patient’s Enduring Power of Attorney or Substitute Decision Maker has signed the form.
If this patient has been seen by Wound Innovations within the last 3 months and you are referring them for the same wound you do not need to complete the form below. Please email firstname.lastname@example.org directly and an appointment will be scheduled. If it has been longer than a 3 month period since the patient was seen please select Re-Refer from the drop-down menu below. If the patient is a current patient but you are referring different wounds please select Additional Wounds from the drop down below.