REFERRALS
Medical and Health Professionals can refer clients to the Epilepsy Foundation. To make a referral, please download and complete the form below, then follow the instructions for forwarding the form to the Foundation.
Complete electronically
Referral form (Word document) - download and complete this form electronically (you can print and save it too) and email to epilepsy@epilepsy.asn.au
Complete manually
Referral form (pdf) - download and print, then complete the form in writing, and either:
- fax it to the Foundation on 03 9882 7159
- mail to 818 Burke Road, Camberwell Vic 3124 or
- scan and email to epilepsy@epilepsy.asn.au
Further information:
For further information or assistance in making a referral, kindly telephone the Epilepsy Helpline 1300 852 853.
