QCIDD CLINIC CHECKLIST
For
NEW PATIENTS
prior to your appointment
 
Referral from your GP
If your referral has come from a medical specialist other than your GP, it is still important that we
have a referring GP on file.
Please note
: referrals to Dr Cathy Franklin can
only
be made by a GP (not by a medical
specialist) and should state that the referral is for “
an assessment and management plan
”.
Completed Pre
-
Appointment Questionnaire
including completed consent form by the person or
statutory health attorney
Any
other relevant medical reports, and assessment records
For
ALL PATIENTS
we require you to bring to EVERY appointment:
Current Medicare card and concession cards
List of current medications
Actual medication (Webster pack if used)
Any medical test results (X rays and X ray reports, blood test reports etc)
Medical/health information such as copies of letters or reports from other doctors, psychologists,
speech pathologists, occupational therapists etc
Behaviour charts and records with a copy of a current behavior support plan
Other charts/records e.g. seizure charts, bowel charts, menstrual charts etc
Please also ensure that the person is accompanied by someone who knows the person and their
history well.
While sometimes emergencies happen or history is not available, please be aware that lack of adequate
records and inadequate knowledge of the person and their history will impact on the quality of QCIDD’s
assessment and the effectiveness of the clinical consultation
.
Your effort in assisting us by providing this information and consistency in support people is appreciated.
PLEASE ADVISE IF YOU ARE UNABLE TO ATTEND THE APPOINTMENT AS OUR WAITING LISTS ARE LENGTHY.
All appointments are run close as possible to times allocated and if you are late you may not receive
the full time allocated. If you have cancelled two consecutive appointments you will be placed back on
the waiting list, unless there are exceptional circumstances (e.g. hospitalisation, etc.). We need to be
Adopted November 2007