Your Pathway to Advanced Nursing Care

Connecting patients, families, and healthcare professionals to trusted nursing care. Submit a referral for yourself or a patient — our Nurse Practitioner led team will coordinate timely, high quality care.

Patient First Name

Patient Last Name

Patient Address Line 1

Patient Address Line 2

Patient City

Patient State

Patient Post Code

Patient Mobile Number

Patient Home Number

Patient Date of Birth

Date of Birth

Patient Gender

Patient Primary GP

GP Phone Number

Please select the type of care we can help you with

Wound Care

Diabetes Care

Stoma Care

General Nursing Care

In Home Nursing Care

Telehealth Consult

Continence Care

Nursing Care Plan Review

Aged Care Nursing Support

Lymphedema Care

Post-Operative Care

Other Care Required

Referrer Details

Complete this section if you are referring on behalf of a GP clinic, specialist, or organisation.

Your Organisation

Your Contact Number

Your Position/Title

Your First Name

Your Last Name

Your E-Mail Address

Privacy Statement

Healthcare United complies with all Australian privacy and health‑information legislation. Your information is stored securely and used only for coordinating your care. Our full privacy policy is available upon request.