General Practitioner (GP) e-Referral Form

Interprofessional collaboration for better patient care 

Thank you for choosing Oriental Melaka Straits Medical Centre as your trusted healthcare partner. We value your confidence in us and look forward to providing high-quality care for your patient.

Our online Patient Referral Form is designed to foster interprofessional collaboration, ensuring better patient care through teamwork and shared expertise. By going digital, we can improve the quality of care for our community while also helping the environment. Skip the printer and join us in making a positive impact!

Referring a patient to 
Oriental Melaka Straits Medical Centre

• Scan the GP e-Referral Form QR code or click HERE to access the form.
• Fill in your patient’s details and the diagnosis.
• Submit the completed form.
• A copy of the e-Referral Form will be emailed to your registered email.
• You may print a copy of the e-Referral Form for your patient.
• If you prefer a hardcopy referral form, please contact our Marketing Department at
  +606-3158877 / +606-3158959.