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

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REASONS FOR REFERRAL

INVESTIGATIONS PERFORMED

PRIVATE AND CONFIDENTIAL MEDICAL QUESTIONNAIRE

REFERRED BY

Click or drag a file to this area to upload.

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.

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