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  QUICK REFERRAL

  Referral is easy. Please contact us using the form below. We will respond within 2 days setting out the options for referral, including whether the patient is eligible to be covered by any DHB funding, according to our contracts.

  Referrer:

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  Referrers Address:

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  Referrers Email:

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  Patient Name:

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  Patient NHI Number:

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  Patient DOB: Sex M/F: MF

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  Ethnicity:

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  Main Diagnosis:

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  Why the patient needs QE:

  Rheumatology Specialist
  Physiotherapy
  Occupational Therapy
  Orthotics
  Psych/Counselling
  Spa
  

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  Comorbilities, allergies:

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  Additional Info:

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Your benefits

Because our focus is on patients where the best possible local services have been tried, referral to QE Health offers the following advantages:

1) a tried and true intensive rehabilitation programme which improves patients’ quality of life. Please refer to our Patient Health Outcomes section for evidence of the effect of our rehabilitation. No one else in NZ or Australia is set up to deliver the same mixture of programme intensity and range of services.

2) patients are aware of their disease and the self management options they can use in managing it. This makes for more independent patients, who utilise less health care resources after rehabilitation.