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Primary Care (EPC)

• Program Referral Form for Allied Health Services under Medicare

Electronic Templates:

(Do not open templates outside the clinical software.  Please refer to the template download instructions - Medical Director or Best Practice - if in doubt about how to proceed.)

• Care Plan Templates - Medical Director 
  • GPMP (MBS Item 721) Template
  • TCA (MBS Item 723) Template
  • GPMP & TCA (MBS Items 721 & 723) Template
  • Review of GPMP (MBS Item 732) Template
  • Review of TCA (MBS Item 732) Template
  • TCA (MBS Item 723) Cover Letter Template
• Care Plan Templates - Best Practice
  • GPMP (MBS Item 721) Template
  • TCA (MBS Item 723) Template
  • GPMP & TCA (MBS Items 721 & 723) Template
  • Review of GPMP (MBS Item 732) Template
  • Review of TCA (MBS Item 732) Template
  • TCA (MBS Item 723) Cover Letter Template

• Care Plan Checklists
  • GPMP (MBS Item 721) Checklist
  • TCA (MBS Item 723) Checklist
• Health Check Templates - Medical Director & Best Practice
  • 45 - 49 Year Old Health Check (MBS Items 701, 703, 705 & 707) Template
  • ATSI Adult Health Check (MBS Item 715) Template
  • ATSI Child Health Check (MBS Item 715) Template
  • ATSI Older Persons 55+ Health Check (MBS Item 715) Template
  • Comprehensive Medical Assessment (MBS Items 701, 703, 705 & 707) Template
  • Healthy Kids Assessment (MBS Items 701, 703, 705 & 707 or MBS Item 10986) Template
  • Healthy Kids Assessment (MBS Items 701, 703, 705 & 707 or MBS Item 10986) Recall Letter
  • Intellectual Disability Health Assessment (MBS Items 701, 703, 705 & 707) Template
  • Older Person's Health Assessment (MBS Items 701, 703, 705 & 707) Template
  • Older Person's Health Assessment (MBS Items 701, 703, 705 & 707) Recall Letter
  • Refugee Health Assessment (MBS Items 701, 703, 705 & 707) Template
• Health Check Templates - Medical Director
  45 - 49 Year Old Health Check (49 Year Old) Recall Letter
  45 - 49 Year Old Health Check (At Risk) Recall Letter
  45 - 49 Year Old Health Check (May Be At Risk) Recall Letter
• Health Check Templates - Best Practice
  45 - 49 Year Old Health Check (49 Year Old) Recall Letter
  45 - 49 Year Old Health Check (At Risk) Recall Letter
  45 - 49 Year Old Health Check (May Be At Risk) Recall Letter

Paper Templates:

• Care Plan Templates
  • GPMP (MBS Item 721) Template
  • TCA (MBS Item 723) Template
  • GPMP & TCA (MBS Items 721 & 723) Template
  • Review of GPMP (MBS Item 732) Template
  • Review of TCA (MBS Item 732) Template
  • TCA (MBS Item 723) Cover Letter Template

• Health Check Templates
  • 45 - 49 Year Old Health Check (MBS Items 701, 703, 705 & 707) Template
  • 45 - 49 Year Old Health Check (49 Year Old) Recall Letter
  • 45 - 49 Year Old Health Check (At Risk) Recall Letter
  • 45 - 49 Year Old Health Check (May Be At Risk) Recall Letter
  • ATSI Adult Health Check (MBS Item 715) Template
  • ATSI Child Health Check (MBS Item 715) Template
  • ATSI Older Persons 55+ Health Check (MBS Item 715) Template
  • Comprehensive Medical Assessment (MBS Items 701, 703, 705 & 707) Template
  • Healthy Kids Check (MBS Item 10986) Template 
  • Intellectual Disability Health Assessment (MBS Items 701, 703, 705 & 707) Template
  • Older Person's Health Assessment (MBS Items 701, 703, 705 & 707) Template
  • Older Person's Health Assessment Recall Letter

45 Year Old Health Check (MBS Items 701, 703, 705 & 707) Resources:

• Business Case and Organisational Issues to Consider
• Checklist
• Practice Detailing Card
• Practice Poster
• RACGP Clinical Resources
• Presentation
• SNAP & Red Book Reference Kit

Other Resources:

• Chronic Condition Self-Management - Guidelines for GPS, Nurses and Allied Health Professionals
• EPC & CDM Item Numbers - Finding Your Way Through The Maze (once opened, click on the chart for more information)
• Australian Type 2 Diabetes Risk Assessment Tool