Health and Medical Fax Cover Form - Queensland

QUEENSLAND CORRECTIVE SERVICES
ADMINISTRATIVE FORM – STANDARD FACSIMILE SHEET
Availability: Public Implement Date: 28 August 2006
To: ............................................................................................................................
Fax. No: ....................................................................................................................
From: Consultant, Health and Medical Services
Telephone: (07) 3227 6501
Fax: (07) 3405 6301
Subject: ...................................................................................................................
Date: .......................................................................................................................
Message:
Should the following prisoner be admitted to your facility please contact
Health and Medical Services for relevant forensic discharge information:
Name: .............................................................................
Date of Birth: .............................................................................
Should you have any difficulties in receiving this fax, please contact ................................
on (07) 32276501
No. of Pages ........... (including cover sheet)
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