For health professionals

Contact Harmony about a referral.

Send the basic details we need to identify the patient or client, contact the referrer and direct the enquiry to the right team.

Add your details

Tell us who is referring so our team can respond directly.

Identify the patient

Provide their name and date of birth only.

Keep the request brief

Tell us which service you need or the question you would like answered, without including health history or reports.

We contact you

Harmony will follow up with the referrer if more information is needed.

For practitioner use

Referral request

This form collects only the basic information needed for Harmony to contact the referrer and direct the enquiry. Please do not include medical history, diagnoses, medication details, test results, risk information or reports. If a matter is urgent or time-sensitive, please call us.

Referring practitioner

Full name *Profession *Practice or organisationProvider numberEmail *Phone *

Patient or client

Full name *Date of birth *

Referral request

How can Harmony help? *Please keep this brief. Do not include clinical history, diagnoses, medications, investigation results, risk details or other sensitive health information.

ConsentI confirm that the patient/client (or their authorised representative) has consented to Harmony receiving this referral request and contacting the referrer. *

For urgent or time-sensitive matters, call 02 4658 2258.