Peel Health Campus
Part of Ramsay Health Care

Referral and Admission Forms

Please note that public endoscopy bookings are open access and must be submitted on the approved referral form below either in Word or in one of the practice management software formats. This should be emailed to

Public endoscopy referrals submitted by other means will be rejected.

Private endoscopy referrals must be directed to the chosen gastroenterologist or general surgeon. Click here to search for a specialist or to download the PHC VMO Directory

Public Endoscopy referral formats

Request for Direct Admission to PHC by Doctor

Doctors must submit the following form to the Duty Nurse Manager where a patient needs direct admission to PHC. If there are any queries please call 08 9583 6242 or Reception on 08 9531 8000 and ask for the Duty Nurse Manager.