Pharmacy and allied health referral Diabetes Australia – Tasmania We welcome referrals from pharmacists, pharmacy assistants, allied health practitioners and community/case care workers from anywhere in Tasmania. Our clinical, COACH and group programs are FREE for people with, or at risk of diabetes. Individual consultations are offered via telehealth, video as well as face to face. With the patient’s consent, please complete the referral form below and one of our health professionals will contact the patient and talk to them about how we can help. FREE Services & Programs Diabetes Educator and Dietitian Clinics Nurse Practitioner Clinics Group Educational Sessions (DESMOND and SMARTS) Telephone health coaching – The COACH Program Healthy Living Events Type 1 Diabetes youth activities View our full services and programs here. Pharmacy and Allied Health Referral – Tasmania "*" indicates required fields Referring PersonReferrer Organisation* Referrer Full Name* Referrer Position* Referrer Phone* Referrer Email* Reason for referring*Client DetailsName* Date of Birth* GenderGenderMaleFemaleOtherAddress* Phone* Email* Client’s DiagnosisDiagnosis* At risk Pre-diabetes Type 2 Type 1 diabetes, gestational diabetes and other can be referred to NDSS groups. Eligibility for diabetes educator and dietitian clinics are not met. Regular GP Name* Regular GP Practice* Regular Endocrinologist Name (if applicable) Client ConsentDiabetes Tasmania will only contact this client if they have provided consent for this referral. Does the client consent to a Diabetes Tasmania Health Professional contacting your regular GP to obtain health record information (including recent HbA1c results)? Consent*Choose oneYesNoA Diabetes Tasmania health professional will discuss this referral with the client prior to booking an appointment. Diabetes Tasmania offers one on one appointments with a Diabetes Educator or Accredited Practising Dietitian, a free telephone based health coaching service and group education programs to help your client better manage their diabetes.