BGB Health Care Clinic Referral Form
'Better Growing Bodies'
If you wish to refer to Dr Sahil Vohra General Physician (Internal Medicine Specialist) please fill in the online form below
Locations offered: Hunter Valley Private Hospital Consultation Rooms, Health HQ Salamander Bay or Telehealth Consults
Patient- First name
*
Patient- Last Name
*
Address
*
Phone Number
*
DOB
*
Reason for referral
Urgency of appointment
Urgent 1-2 weeks
Semi urgent 2-4 weeks
Health Summary, Blood results and/or attachments
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Referring Doctor Details
Doctor - Name
Doctor's Provider's number
*
Date of Referral
Comments
Peri-Operative Services
For Referring Surgeons
What surgery is patient requiring
Left total knee replacement
Right total knee replacement
Left total hip replacement
Right total hip replacement
Other
Date of surgery
Further information we should know
Hospital for surgical procedure
Lingard Private Hospital
Maitland Private Hospital
Hunter Valley Private Hospital
Newcastle Private Hospital
Other
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