Criteria for referral to public hospital specialist clinic services

• Chronic headache with concerning clinical signs
• Concerning features on neuroimaging (excluding age-appropriate deep white matter)
• Severe frequent migraine impacting on daily activities (e.g. work, study, school or carer role) despite prophylactic treatment
• Chronic or atypical headache unresponsive to medical management (e.g. cluster headache, trigeminal neuralgia, medication overuse headache).

Information to be included in the referral

Information that must be provided

• Onset, characteristics and frequency of headache
• Current and complete medication history (including non-prescription medicines, herbs and supplements)
• Any medicines previously tried, duration of trial and effect
• Erythrocyte sedimentation rate and C-reactive protein for patient > 50 years, or if giant cell arteritis or vasculitis suspected
• Details of any previous neurology assessments or opinions.

Provide if available

• Neuroimaging results
• If symptoms are thought to be linked to probable or confirmed SARS CoV-2 (COVID-19) infection or Long COVID.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

• Mild or tension headache
• Untreated typical migraine
• Isolated migraine in patients with an established diagnosis
• Chronic migraine already being managed by a neurologist.