Peter MacCallum Cancer Centre REFERRAL FORM Sign and fax - petermac 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the patient details, including their last name, first name, date of birth (D.O.B), and address. Ensure all fields are filled accurately.
  3. Indicate the referral date and whether the patient is Medicare eligible by selecting 'Yes' or 'No'.
  4. Specify appointment requirements such as interpreter needs or accommodation assistance. If an interpreter is required, mention the language.
  5. Select the services you wish to refer the patient to. If unsure, choose 'All services' for a comprehensive assessment.
  6. Fill in the reason for referral and specify if this is for a second opinion. Indicate how long the referral should be valid.
  7. Complete relevant investigations/attachments by ticking applicable boxes and provide any additional comments.
  8. Finally, fill in your details as the referring doctor, including your name, practice name & address, provider number, phone number, and mandatory signature before submitting.

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Admissions Arrange for a health care professional, such as your GP (General Practitioner), to refer you to us. You can download a Welcome to Peter Mac please read this end to end. Bring the following to your appointment: Your appointment letter. Come to Peter Mac on the day of your appointment.
Admissions Arrange for a health care professional, such as your GP (General Practitioner), to refer you to us. You can download a Welcome to Peter Mac please read this end to end. Bring the following to your appointment: Your appointment letter. Come to Peter Mac on the day of your appointment.
Peter Mac provides cancer treatment and care in collaboration with partners within the Parkville Biomedical Precinct, in particular The Royal Melbourne Hospital and the Royal Womens Hospital. We partner with many organisations and networks worldwide. This helps us to improve the quality of our cancer services.

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People also ask

Peter Macs history had humble beginnings, starting in just one room of the then Queen Victoria Hospital in Melbourne. The inaugural meeting of the board was held on 27 April 1949, with the first outpatient clinic named in Sir Peters honour in 1950.
If you need help, you can: Call the telehealth team on (03) 8559 7578. Email telehealth@petermac.org.
If the referral is accepted, we will organise an appointment. Appointment details are usually sent by post, but we will phone you if an appointment has been scheduled within two weeks. Peter Mac is a public hospital and cancer treatment and care is provided free of charge to patients who are eligible for Medicare.
We are driven by a mission to extend worlds best cancer care. We deliver world-class cancer education and training through our external partnerships, and support entities seeking our unique insight and expertise to build their own capability in cancer care.
Our values of Innovation, Excellence and Compassion underpin our approach to recruitment. Welcoming people from a wide variety of backgrounds and experiences is critical.

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