Community Outreach Referral Forms

Please click on the following links to download patient referral forms for:​

• Liver Disease Severity and Fibrosis Assessment​
• Hepatitis B: New Patient Enrolment into the HOTTeR West Program ​
• Hepatitis C: Referral to the Community Outreach Hepatology Service 
• Hepatitis C: Remote Consultation

If you have any questions about the referral forms above you should contact us by email WSLHD-HepatologyService@health.nsw.gov.au or telephone on 0407 141 139 , we will be happy to assist you with the process.

Contact Us 
WSLHD-HepatologyService@health.nsw.gov.au