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Tinnitus – Other

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • No category 1 criteria

Category 2

Appointment within 90 days is desirable

  • Bilateral and disabling with significant concerns about wellbeing (Tinnitus Handicap Inventory Score ≥ 4 or TRQ > 17)

Category 3

Appointment within 365 days is desirable

  • Bilateral and disabling (Tinnitus Handicap Inventory Score < 4 or TRQ  ≤ 17)

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • Refer to Health pathways or local guidelines
  • For Tinnitus Handicap Inventory Score > 4, consider concurrent psychology referral
  • Patient education/tinnitus management advice
  • Chronic tinnitus consider referral to:
    • private audiology for hearing aid if hearing loss present, masking hearing aid, tinnitus retraining therapy.
    • public/private audiology for patient education/tinnitus management advice
    • psychologist
  • Unilateral tinnitus may require investigation for retro cochlear lesion; consider Imaging for investigation of
    retro cochlear lesion (Health Monash, 2014)
  • Consider referral to a Dentist &/or Physiotherapist if associated TMJ dysfunction are suspected

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • Onset
    • functional impact of tinnitus
    • associated symptoms
  • ENT/Otological history (history of middle ear disease/surgery etc.)

Additional Referral Information (Useful for processing the referral)

  • Psychological history
  • Documented TMJ or recent dental work (Dental/Physiotherapist as necessary)
  • Any intervention and its effect

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
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