Book Appointment

Call or Email us
Phone  (08) 81511333
Fax   (08) 81511334
Email   [email protected]

Telehealth / Phone appointment
It is possible to schedule some appointments via telehealth, in particular for patients living in remote or regional areas.

Appointment requirements
For general appointments, we require a valid referral letter (from a GP or specialist) to be sent by email, fax, post, or in person.
We also require a Patient Detail Form which can be completed below.

Patient Detail Form

* Indicates required field

First name *

Date of Birth *

Phone number *

Email Address *

Last name *

Height (cm) *

Weight (kg) *

Occupation *

Address *

Insurance Status *

Privately Insured Self Funding Overseas Cover

Health Fund Name *

Date of Joining Fund *

Fund Membership Number *

Fund Excess Amount (if applicable) *

Medicare Number *

Veteran Affairs Number (if applicable) *

Pension Health Care Card Number (if applicable) *

Name of GP *

Name of Referring Doctor (if not GP) *

Next of Kin (Emergency Contact Person) *

Relationship to You *

Phone Number *

Can we share information with next of kin? *

Yes No, please do not share info with next of kin

Medications List *

Any Allergies? *

I acknowledge I have read + understand the privacy policy below *

Yes

Submit