ReFerral Forms

Whilst a referral is not necessary for an individual to access Kinetic Medicine’s services, anyone seeking a Medicare rebate or Department of Veteran’s Affairs entitlement require an eligible referral. Individuals referred from other medical professionals are encouraged to complete the private referral form to ensure continuity of care.

Chronic Disease Management Referral

Chronic Disease Management

A GP must complete this form as part of a Chronic Disease Management Plan in order for a patient to receive a Medicare rebate on services

Type Two Diabetes Groups referral

Type 2 Diabetes Group

A GP can complete this form as part of a team care arrangement. Eligible patients with type II diabetes can receive an initial assessment and 8 group services on this referral through Medicare

Kinetic Medicine Referral

Private referral

Medical and allied health professionals seeking to refer patients for shared care with Kinetic Medicine are encouraged to complete this form

D904 DVA Referral

D904 DVA Referral

Eligible Veterans with a White or Gold Card are able to use this referral form when completed by their GP to access services funded by the Department of Veterans Affairs for recognised conditions.


Electronic referrals

Our practice uses ConnectingCare, an encrypted digital medical messaging service compatible with practices who have this capability in their practice management software. Please send referrals to