Brisbane Medical Practice Management Services

Contact & Support Form for Referrers

Please use the form below to submit requests for information, contact specialists, report resends etc. This ensures we can direct your enquiry to the most appropriate person to support you

Hidden
Date Submitted
DD slash MM slash YYYY
Type of Support Request*
Requesting Practice Name*
Your Name
Prefix First Last
Best Phone No*
Best Email*
Enter Email Confirm Email
Specialist/s?
Which Specialist/s
Upload Documents
Please scan or attach relevant information here. Please ensure it is placed on a flat surface to minimise blurring of your image and is no bigger than 150mb in size. (PDF,PNG and JPG files only).
Drop files here or

Accepted file types: pdf, png, jpg, Max. file size: 150 MB, Max. files: 5.
Questions or Comments here:
To enable us to help you please provide as much information as possible
CAPTCHA
Report Re-send Request
This can be used to request a report be re-sent to you. If the request is for the report to be provided to another provide, please call. In the interests of patient privacy, please provide the following information.
Patient first name INITIAL only
Patient surname in full
Date of patient's Appointment
Please indicate the date the patient had their appointment with Redlands Specialist Centre so we can correctly locate the relevant report
DD slash MM slash YYYY
Which Specialist was/is the appointment with?
Please note this form is submitted on a website with a security certificate in place. All urgent matters should be made by phone. For general support enquiries we attempt to respond within 24hrs.

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Referrers Contact Us

Contact & Support Form for Referrers

Report Re-send Request