CQ077 Podiatry Referral bForm v1b2 - Queensland Health - health qld gov 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the patient's identification details, including family name, given name(s), date of birth, and contact number. Ensure accuracy for effective communication.
3. Select the appropriate risk category (High Risk, At Risk, Low Risk) by checking the corresponding box. This helps prioritize patient care.
4. Fill in the medical history section, detailing any relevant conditions such as diabetes or peripheral arterial disease. Attach a full medical history and medications list if necessary.
5. In the reason for referral section, specify whether it's for wound assessment and management or other foot pathologies. Include any additional information that may assist in treatment.
6. Review all entered information for completeness and accuracy before submitting. Use our platform’s features to save your progress or share with colleagues.

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