Medical professionals can submit a referral form online. Complete the details below and once submitted, the referral form will be automatically sent to wmh@cabrini.com.au.
For further enquiries, please email wmh@cabrini.com.au or phone (03) 9508 5100.

PATIENT DETAILS

NEXT OF KIN DETAILS

REFERRING PSYCHIATRIST/GP DETAILS

REASON FOR ADMISSION

PSYCHIATRIC HISTORY AND PREVIOUS PSYCHIATRIC ADMISSIONS

Psychiatric History (diagnoses, medications etc.) and Medical history

ANY OTHER RELEVANT DETAILS