Client Registration Form


CLIENT REGISTRATION FORM

Are you happy to receive SMS appointment reminders?
Do you have private health insurance EXTRAS COVER?
How did you hear about our Practice?
Do you have a written referral?
Is this consultation
  • Payment of consultation is required on the day 
  • We accept cash, cheque, EFTPOS and credit card (Mastercard/Visa) 
  • Direct Health Fund claiming on the spot is available through HICAPS