Chronic Disease Management Templates

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Hurstville 2220
New South Wales Australia
Tel 02 9585 2044
Fax 02 9585 2144
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Medical Director has an extensive range of templates available, which you can accessaccess using the letter writer and selecting the supplied tab.The St George Division ofGeneral Practice has modified a rangeof templates, which are available below.

Please read or print a copy of the Downloading & Importinginstructions

WARNING

FOLLOW DOWNLOAD & IMPORTING INSTRUCTIONS TO AVOIDCORRUPTING

DOCUMENT AND NOT FUNCTIONING CORRECTLY IN MEDICAL DIRECTOR.

Chronic Disease Management - Please view GP Checklist

Combined Item 721 and 723	GP Management Plan Review 725
45 year old Health Check 717	Team Care Arrangement Review 727
Asthma Cycle of Care

Life Scripts


Smoking	Nutrition	Alcohol	Physical Activity
Guidelines	Guidelines	Guidelines	Guidelines
Assessment	Assessment	Assessment	Assessment
Prescription	Prescription	Prescription	Prescription

Mental Health

ATAPS Referral Form	(DOC)	MH Treatment Plan (Item 2710 or 2702)	(DOC)
DASS 21 Response Sheet DASS 21 Response Sheet	(RTF) (PDF)	DASS 21 Scoring & Values DASS 21 Scoring & Values	(PDF) (RTF)
Edinburgh Response Sheet Edinburgh Response Sheet	(PDF) (RTF)	Edinburgh Scoring Template Edinburgh Scoring Template	(PDF) (RTF)
K - 10 Response Sheet K - 10 Response Sheet	(PDF) (RTF)

Allied Health

Allied Health Referral	Diabetes Group Referral (MD version)
Dental Referral Form - Medicare(RTF)

Medication Reviews


Home Medicines Review - Referral	Nursing Home Medication Review
Home Medicines Review - Plan

Aged Care


Comprehensive Medical Assessment (PDF)	Comprehensive Medical Assessment(RTF)
GPMP - Palliative Care(RTF)	75 year old Health Assessment(RTF)
	75 year old Health Assessment(PDF)

Other Templates


Healthy at Home (SAFTE)	4 year old Health Check(RTF)