Urgent Referrals

Dr Rose Mak
Consultant Dermatologist
Phone: 03 8535 4798
Fax: 03 9015 6543

Urgent Referrals
Online Form For Referring GPs

Urgent appointments within 48 hours are available upon request.

Complete and submit the form below and we will be in contact with you to arrange an urgent appointment, for your patient, with Dr Rose Mak.

First Name:

Last Name:

Phone / Mobile:

Email:

Suburb/Town:

Postcode:

Age:

For other reason, specify here:

Dr First Name:

Dr Last Name:

Practice Address / Location:

Phone:

Provider Number:

We endeavour to see urgent referrals within 48 hours.