Maternal Fetal Medicine

Standard referral guidelines

If the referral is incomplete or contains insufficient information it may be returned.

To help with the accurate categorisation of patients referrals please ensure as much information as possible is provided.


  • Date of referral
  • Patient information:
    • Full name, date of birth, contact details, postal address or contact address (if not the same as usual residence)
    • Allergies (drug/ topical preparation)
    • Aboriginal and Torres Strait Islander status (if applicable)
  • Referring practitioner:
    • Full name, address and contact details
    • Provider number and signature
  • Patient referral information:
    • Detailed reason for referral (including the problem to be assessed, degree of loss of function, pain experienced etc.)
    • Relevant information about patient’s condition such as previous medical/ surgical treatment (include systemic and topical medications prescribed for the condition) and any associated medical conditions which may affect the condition or its treatment (e.g. Diabetes)
    • Relevant investigations (pathology, radiology, histology etc), preferably results from within last 4 weeks
    • Current medications and doses, prescribed and over the counter (Note any recent changes in drug therapy)


  • Relevant psychological and social issues impacted by condition (if applicable)
  • Smoking & alcohol history (if applicable)
  • South Sea Islander status (if applicable)
  • Medicare Number (if applicable)
  • Interpreter requirements (if applicable)
  • Patient status – DVA, Work cover, Motor Vehicle Insurance, ineligible (if applicable)

If sufficient information is not provided you and your patient will be notified in writing that we are unable to clinically categorise and place the patient on an appropriate wait list until this information is received. Once a completed referral has been accepted and categorised you will receive advice that your patient has been placed on the waiting list. Please maintain clinical supervision of your patient’s condition prior to the initial consultation with the specialist. Please notify Central Patient Intake (CPI) of any significant change in their condition.

Referral requirements

A referral may be rejected without the following information.

Clinical Details

  • EDC by LMNP Scan
  • G: P: M: O:
  • Blood group / antibody screen
  • Obstetric / medical history
  • Previous scan reports attached
  • BMI / Weight


  • Genetic counsellor
  • MFM antenatal opinion/preconception counselling
  • Pregnancy options counselling

MFM Procedures

  • CVS – 11-14 weeks
  • Amniocentesis from 16 weeks
  • Fetal echocardiography and consultation

Tertiary Obstetric Ultrasound

  • Nuchal translucency +/- karyotype (11+3 wks – 13+6wks)
  • 18 – 20 week morphology ultrasound
  • Tertiary morphology ultrasound – high risk pregnancy
  • Tertiary ultrasound – fetal structural anomaly
  • Rh disease / alloimmunisation; platelet alloimmunisation
  • Fetal growth and wellbeing ultrasound
  • Multiple pregnancy
  • Cervical length measurement
  • Other (e.g significant maternal medical history – SLE, Renal, Cardiac, Drug/ Alcohol Exposure)

For Royal Brisbane and Women’s Hospital referral and imaging requests, complete the Referral/Imaging Request Form.

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander
  • 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
  • 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
  • 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
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • 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.)

Specialists list

Send referral

Hotline: 1300 364 938

Fax: 1300 364 952

Electronic: eReferral system

Mail: Metro North Central Patient Intake
Aspley Community Centre
776  Zillmere Road

Health pathways

Access to Health Pathways is free for clinicians in Metro North Brisbane.

For login details email:

Login to Brisbane North Health Pathways:

Back to top