Refer a Patient

Practitioner referral

For general practitioners and specialists. Fields marked * are required. The referral will be acknowledged.

Time-critical cases

This form is not monitored continuously. For acute stroke or other emergencies, activate your local stroke pathway or call 000. For urgent same-week review, please also phone SNIS on 1300 00 7647.

Referrer

Referrer name *

Practice / organisation

Provider number

Phone *

Email *

The acknowledgement and any correspondence will go to this address.

Patient

Patient name *

Date of birth

Patient phone *

Urgency

Clinical details

Reason for referral / clinical summary *

Attach referral letter or documents

PDF or image, up to 4 MB. Imaging itself does not need to be attached; access details or the imaging provider can be noted above.

Email me a copy of this referral

Thank you. The referral has been received and will be acknowledged. For very urgent cases, please also phone SNIS on 1300 00 7647.

For patients

Appointments and enquiries are managed by Sydney Neurointerventional Specialists (SNIS). A referral from your GP or specialist is required.

1300 00 7647 1300 00 SNIS · Monday to Friday Visit the SNIS website

Already have a referral?

If your doctor has given you a referral to Dr Mitchelle, you can send it here and the practice will contact you to arrange an appointment.

Practitioner referral

Referrer

Patient

Clinical details