Referral Forms

In order to provide the best possible care for your patient we request a completed referral form be sent to our office via fax 08 9355 5718 or email This ensures your patients are seen in a timely fashion and facilitates efficient communication about their treatment

Please click on the PDF icon next the referral form you would like to download.

Perth Diabetes Care Referral Form

Allied Group Referral Form

Medicare TCA Referral Form

Insulin Support Programs

Opening Hours : Mon, Tue, Wed & Fri - 8.00am to 5.30pm, Thu - 8.00am to 6.30pm, Sat - 8.00am to 4.30pm, Sun - 8.30am to 11.30am
Contact : P 08 6110 0570 | F 08 9355 5718 | E
HQ Address: 968B Albany Hwy, East Victoria Park WA 6101

PDC Allied Health is provided by Perth Diabetes Care. Multidisciplinary Allied Health for all chronic conditions and skilled in diabetes care.