NEW PATIENTS: Please complete both registration and health questionnaire
EXISTING PATIENTS: Please complete the health questionnaire only if you have not done so prior to May 1st 2020.
This Practice collects information for the primary purpose of providing quality health care.
By completing this online registration form you freely give your consent to access health information including pathology, radiology, surgical and medical information which will be used for health care purposes directly related to yourself/your child/dependent as the patient.
By completing this form you give your consent to be contacted by SMS/Email and participate in Telehealth/Phone consultations where required. Should you not wish to be contacted via these methods please contact the Practice on P: 03 5561 6038 to discuss further.
FEES: I understand that I am financially responsible for the balance of any fees charged beyond the Medicare Rebate or if applicable health fund cover.