Refer a patient

Health Professional Referral Forms

Diabetes WA has a team of qualified and credentialled diabetes educators who provide education and support to people at risk of, or living with, diabetes.

All our programs are FREE, person-centred, evidence-based and are outside the Medicare Benefits Schedule.

Below you will find a list of downloadable, interactive referral forms to use when referring your patient/s to one of our Diabetes Group Education Programs or our Telehealth Service. More information on each program can be found on the relevant program page of this website, or by clicking on the program name in the list below.

Please note that clients may also self-refer into Diabetes WA programs and services.

Workshop guide

Need an overview of what type of workshops are available for whom? Read the workshop guide.

Perth Metropolitan patients – programs for type 1, type 2 and gestational diabetes

Including: DESMOND for type 2, DAFNE for type 1, SMART programs for type 1, type 2 and gestational diabetes.

Download the Diabetes Group Education Referral Form Metro

Regional patients – programs for all types of diabetes

DESMOND for type 2.  Download the DESMOND Type 2 Diabetes Education Referral Form Regional

Diabetes Telehealthfor type 1, gestational and individual consultation where local diabetes services are unavailable. Download the Telehealth Professional Referral Form

Telehealth Endocrinology Service – endocrinology support provided via videoconference, for those living with diabetes in regional and remote Western Australia. Download the Telehealth Endocrinology GP Referral Letter

Pilbara patients – pre-diabetes and type 2 diabetes

Including: DESMOND for type 2 and Walking Away for pre-diabetes and prevention

The Walking Away diabetes prevention program is currently only available in the Pilbara. 

Download the Diabetes Group Education Referral Form Pilbara

NB: Pilbara Health Professionals can also use the Telehealth referral form above for individual consultations for your patient where local diabetes services are unavailable.

Where and when is the next diabetes workshop in my patient’s area?

Check out the calendar on our what’s on page to select your preferred diabetes workshop. To secure a spot for your patient, you can book online or call 1300 001 880. Alternatively send us a completed referral form using one of the links above, and we will contact your patient to book them into a workshop that suits them.

Further Information

If you have any enquiries, please don’t hesitate to contact our Primary Care Coordinator on 1300 001 880 or via email.







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