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P: 03 5176 4994
F: 03 5176 4997
146 Princes Hwy, Traralgon VIC 3844
P: 03 5176 4994
F: 03 5176 4997
146 Princes Hwy, Traralgon VIC 3844
Home
About
FAQs
Doctors
Referrers
Contact
For Referrers
Electronic Referral Form: (To be completed by medical professionals only)
Ophthalmologist
Any Ophthalmologist
Dr Weng Ng
Dr Danielle (Daini) Ong
Dr Raghuvir Kini
Dr Michael Chen
Dr Himanshu Solanki
Patient's First Name
Patient's Last Name
Patient's Contact Number
Patient's Date of Birth
Patient's Email
Appointment Type:
Cataract Assessment
SLT/YAG Laser
Glaucoma
Injection
Diabetic/Retinal Laser
Paediatrics
Oculo-Motility
Neuro-Ophthalmology
Other
Referral details:
Referrer's Name
Practice Name
Provider Number
Referrer's Email
Date
Referral Period
3 months
12 months
Indefinite
Supporting Documents (optional):
Submit
