Department of Health
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Specialty: Children's surgery
Age group: Children

Criteria for referral to public hospital service

  • Microtia, congenital ear anomalies, protruding ears and constricted ears in a child younger than 18 years
  • Traumatic ear deformities in a child younger than 18 years.

Information to be included in the referral

Information that must be provided

  • Findings on physical examination
  • Child’s age
  • If referral relates to injury detail: date, mechanism, severity, recurrence and evolution of injury
  • Functional or psychological impact on quality of life or activities of daily living including impact on work, study or social activities.

Provide if available

  • Colour photograph(s) – with patient's consent where secure image transfer, identification and storage is possible. These images often assist with identifying clinical urgency and the most appropriate specialist clinic or service
  • Statement about the parent(s) or guardian’s interest in having surgical treatment if that is a possible intervention
  • If the child identifies as an Aboriginal and/or Torres Strait Islander
  • If the child is neurodiverse, gender diverse or has a disability
  • If the child has a preferred language other than English and if they rely on cultural or linguistic support (e.g. Aboriginal cultural support, an interpreter)
  • If the child lives in out-of-home care (foster care, kinship care, permanent care or residential care)
  • If the child is aged 14-18 years, do they consent that their health information is shared with their parent, guardian or carer.

Additional comments

The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

Not applicable.

Reviewed 12 August 2025

Statewide Referral Criteria

Contact us

Address
50 Lonsdale Street
Melbourne, VIC 3000

Phone
1300 650 172
National Relay Service

Email
plannedcare@health.vic.gov.au

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