Refer a Patient

Referrers

If your patient needs to be seen within 24 hours please call our team on 1800 111 374.

Please complete the online referral form below or download a PDF copy.

Patient Referral Form

Patient Title

Patient First Name *

Patient Surname *

Patient Date of Birth (DD/MM/YYYY)

Patient Address

Patient Phone *

Patient Email *

Preferred Specialist

Preferred Clinic

Eye Condition

Reason for Referral *

Optometric Details: Refraction

Referrer Name *

Provider No *

Practice Name / Address *

Practice Phone *

Signed by (your name) *

Date *

File Upload: Further Patient Information

Maximum file size: 41.94MB

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Our Specialists

Dr Robert Bourke

Dr Lewis Lam

Dr Sharon Morris

Dr Daniel Allbon

Dr Darryl Gregor

MEET OUR TEAM

Southport

1800 111 374

Ground Floor, 2 Short Street, Southport, QLD 4215

Mon

8:00am to 4:30pm

Tue

8:00am to 4:30pm

Wed

8:00am to 4:30pm

Thu

8:00am to 4:30pm

Fri

8:00am to 4:30pm

Sat

Closed

Sun

Closed

Request Appointment

Varsity Lakes

1800 111 374

Level 2, Bermuda Point, 1 Lake Orr Drive, Varsity Lakes QLD 4227

Mon

8:00am to 4:30pm

Tue

8:00am to 4:30pm

Wed

8:00am to 4:30pm

Thu

8:00am to 4:30pm

Fri

8:00am to 4:30pm

Sat

Closed

Sun

Closed

Request Appointment

Coolangatta

1800 111 374

Level 2, The Strand, 72-80 Marine Parade Coolangatta QLD 4225

Mon

8:00am to 4:30pm

Tue

8:00am to 4:30pm

Wed

8:00am to 4:30pm

Thu

8:00am to 4:30pm

Fri

8:00am to 4:30pm

Sat

Closed

Sun

Closed

Request Appointment