Make an Appointment

In order to make an appointment and claim Medicare benefits you will need a referral from a medical practitioner. Your referring doctor can send the referral by email, post or fax.

Bring your referral to your consultation along with any Xray reports, films, CDs, current medication list and copies of lab tests. Please fill out the patient questionnaire below online and send to us prior to your appointment.

Patient Details

Reasons for Referral (please tick)

Investigations Performed
Private and Confidential Medical Questionnaire
  • if yes, how long?
  • how many per day?
Referred By
Declaration

By submitting this form I acknowledge that this is an accurate medical history and I understand that this information will be treated with complete medical confidentiality and will only be shared with other health personnel involved in my care.