Referral Letter for Consultant Psychiatrist - Dr Daniel Yint
Please Fax the referral to 08 9456 3817. Patient will be contacted for the appointment. 
Dr Daniel Yint
Consultant Psychiatrist
MBBS, FRANZCP, MRCPsych (UK) 
Adult Psychiatrist with special interest in
• Bipolar Disorders 
• Treatment Resistant Depression
• Psychotic Disorders	• Generalised Anxiety Disorders and OCD 
• Post Traumatic stress disorder
• Multicultural psychiatry 	

Brief information required from GPs in the referral:

Patient Demographics
Name: <PtFullName>
DOB: <PtDoB>               Age: <PtAge>                Sex: <PtSex>                                
Address: <PtStreet><PtCity><PtPostcode>
Phone: <PtPhoneMob>  <PtPhoneH>
Any social support:  <Social Support?>
Employement status: <Employement status?>	
	
Date of referral: <TodaysDate>	
Type of referral: <Type of referral>	
Reason for the referral: <Reason for referral?>	
Brief past psychiatric history: <Brief past psychiatric history>	
	
Is the referral discussed with the patient? <Is the referral discussed with the patient?>	
Does the patient agreed for the referral? <Does the patient agreed for the referral?>	
Any current risk issue? <Any current risk issue?>  (Please identify if yes)
<Please identify risk issue if present.>	
Any significant use of illicit Drugs/Alcohol? <Any significant use of illicit Drugs/Alcohol?> (Please specify if Yes) 
<Please specify if any significant Drug/Alcohol use>	
	
Relevant Medical History/Co-morbidities: <SelectedPMH>	
Current medication list: <SelectedRx>	
Allergies: <Reactions>	

Referrer' Details: 
<DrName>
<DrProviderNo>
<DrQualifications>
<DrPhone>
<DrAddress>	Referrer's Signature: