Fluency
Adult

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Useful Management Information

No useful management information

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Chronic or acquired stuttering and/or dysfluency disorders whereby condition has the potential to require more complex or emergent care if assessment and intervention delayed. Indicators for this category: Severe impact on mood or emotional wellbeing.
Category 2 (appointment within 90 calendar days)	Chronic or acquired stuttering and/or dysfluency disorders whereby condition is likely to require more complex care if assessment and intervention is delayed. Indicators for this category: Relapse of stuttering Moderate to severe stuttering symptoms OR moderate to severe impact on activities of daily living/quality of life Moderate impact on mood or emotional wellbeing History of co-occurring anxiety/depression and/or mental health conditions.
Category 3 (appointment within 365 calendar days)	Chronic or acquired stuttering and/or dysfluency disorders whereby condition is unlikely to deteriorate quickly or require more complex care if assessment is delayed beyond 365 days. Indicators for this category: Stuttering since childhood. Chronic mild stuttering symptoms OR minimal impact on mood or emotional wellbeing.
If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Clear reason for referral
History / Duration of symptoms/condition
Medical and social history and list of medications
Results of relevant medical assessments/investigations/management of condition

If a specific test result cannot be obtained due to access, financial, religious, cultural or consent reasons a clinical override may be requested. This reason must be clearly articulated in the body of the referral.

Additional Referral Information

Next of kin details
Patient awareness of referral
Any other health care professionals currently involved (e.g. other Allied Health Professionals, Health Clinicians)
Previous speech pathology or specialist assessment reports
Is the patient seeing a Psychologist and/or counsellor?

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Not Available

Internal Referrals

(E-Blueslips)

Fax

(07) 5687 4497

Post

Allied Health Outpatients
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

(07) 5687 3027

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Facilities

Gold Coast University Hospital

Robina Hospital

Tugun Satellite Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

FluencyAdult