Criteria for referral to public hospital specialist clinic services
- Missing or lost strings on an intra-uterine device
- Request for tubal ligation
- Where hormonal contraception is contraindicated
- Where contraception is unable to be managed in primary care due to a complex medical condition (e.g. immunosuppression, breast cancer, multiple sclerosis, physical disability).
Information to be included in the referral
Information that must be provided
- Past gynaecological history including menstrual health and details of previous experience with contraception
- Relevant family history.
Provide if available
- Most recent human papillomavirus (HPV) and liquid-based cytology (LBC) co-test result or cervical screening test results
- Sexually transmitted infections test results.
The Summary and referral information lists the information that should be included in a referral request.
Referrals should be made to suitable community-based services wherever possible (see 1800 My Options).
Where a public health service also operates a community health service or GP clinic, demand for reproductive health services should be met through these GP clinics.
Cervical screening test results may be provided from either self-collected or clinician collected samples.
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
- Reversal of tubal ligation.
Note the statement on reversal of sterilisation in Victoria’s Elective Surgery Access Policy 2015.