Referral Process

DASWest Programs have differing referral requirements.

Please see the referral requirements noted on the relevant Client Journey Map on the DASWest Programs and Services  page, or access the.DASWest Referral A4 Programs and Services 0710.pdf (476KB)


DASWest Pro-forma Referral Forms:

Generic DASWest Referral Form:

Click on following link: DASWest Referral form .pdf (63KB)

 Homeless Dual Diagnosis Program.
Click on following link: Referral to DASHomeless Dual Diagnosis Clinician.pdf (58KB)

GP / Medical Specialist referrals:
A GP / Medical Specialist referral is required for the following programs:

  • Addiction Medicine Outpatient Clinics
  • Specialist Pharmacotherapy Program

All GP / Medical Specialist referrals must have the following minimum information:

  • Patients surname, first name, date of birth, current address, phone contact (day time) and Medicare Number
  • Your surname, first name, Provider number, Clinic name and address, Clinic telephone number
  • Reason for referral / diagnosis, relevant past history, including substance misuse history, current medications, including pharmacotherapy and prescriber details, relevant diagnostic investigations, attempted treatments / interventions / actions
  • The referral must be legible (Typed referrals are preferred)

When referring to DASWest Addiction Medicine Outpatient MBS Clinics the following additional minimal information is also required:

  •  Evidence of informed consent from patient to attend
  • Referral letter must state the Addiction Medicine Specialist's name
  • Patients are to be advised to attend with their Medicare card


Note: There is no out of pocket charge for DASWest patients/ clients attending an MBS Clinic

General Practitioners are encouraged to refer to DASWest using the Victorian State-wide Referral Form (VSRF). This form can be accessed via our GP Liaison webpage by clicking on the following link GP Liaison - Outpatients


Self Referral:

Clients may self refer by phone for the following programs:

 

Program Phone No

Community Residential Withdrawal Program

8345 6730

Home Based Withdrawal Program

8345 6682

Women and Children's Program

9687 4177

Youth and Family Services

9689 5533