Upload Referral Upload file *Choose FileNo file chosenDelete uploaded filePatient/Examinee's name:Examinee's EmailPhoneYou must read thisPlease note the following before submitting a referral: • Do not upload urgent referrals or information indicating risk of harm to self or others. In such situations, please contact appropriate emergency or crisis services or discuss the referral directly with Dr Pokharel. • Please be advised there may be a waiting period of several weeks before new patients can be seen. • Regular assessment and ongoing care referrals are not accepted at this stage. • Please refer to the Clinical Services and Medico-Legal tabs above for the types of referrals that are accepted. • For situations involving acute mental health risk, please follow the directions provided at the bottom of the Clinical Services page.Consent *I confirm I am authorised to submit this referral and the attached documents and that the information is provided in accordance with applicable privacy and consent requirements.Consent *By submitting this referral: I am seeking a one-off psychiatric assessment under Medicare Item 291 or Item 293. I understand I will have to liaise with my GP for treatment and care for my mental health. I understand that this service is consultative in nature and does not provide ongoing psychiatric treatment or an administrative/legal report. I understand that continuation of existing medications is not guaranteed and will be subject to clinical assessment I agree to pay the applicable consultation fees in full at the time of the appointment Submit
