Online Referrals

Online referrals to Mr Freedman:

We prefer to receive referrals via Fax, Email or Argus.

However, doctors (or allied health practitioners) can refer patients to us online by completing this online form.
Please do follow up with a referral to our rooms on (03) 9532 3333.

Supplementary information or medical reports should be faxed to our office on Fax: (03) 9682 0203.
Our office staff will contact the patient as quickly as possible.

Disclaimer: This online form is not an emergency referral service. For urgent matters please contact Mr Freedman directly on his mobile phone or via the hospital switchboard at Mulgrave Private Hospital. For emergencies please contact your local emergency department.

Patients wishing to make a self referral: You may book an appointment prior to receiving a referral from your doctor but for medicare rebate purposes you will need a valid medical referral. Please contact your doctor to ensure that they do send a referral for you.

Patient Details
Name*
First Last
D.O.B*
DD slash MM slash YYYY
Contact Number*
Referrer Details
Name*
First Last
Contact Number*
Provider Number*
Practice Name*
Referral Clinical Details
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Online referrals to Mr Freedman:

Patient Details

Referrer Details