If you have been referred to JY Exercise Physiology by your GP, specialist, or allied health professional, please complete the referral form below to begin your care.

This is for clients referred for exercise physiology services, including Medicare Chronic Disease Management (CDM/EPC) plans, NDIS, DVA, WorkCover, and private referrals. Completing this form allows me to review your referral and tailor your exercise program to your specific health needs and goals.

Please ensure you attach any relevant documents, such as:

• GP or specialist referral letters

• Chronic Disease Management (CDM/EPC) plans

• Medical reports, imaging, or hospital discharge summaries

If you are unable to attach the documents to this form, feel free to email or bring them in-person.

Once your referral and documents are received, JY Exercise Physiology will contact you to organise your initial consultation and discuss next steps.

If you need help completing this form or have questions about exercise physiology referrals, please contact me directly.