New Patient Information Form – Welcome!

You are at this page because you have chosen to fill in your personal details and medical history on line. Except in emergencies, we will need to receive your completed form at least 2 working days prior to your appointment otherwise your appointment may have to be rescheduled.

You will also need to ensure any relevant X-Rays and your referral are received in advance of your appointment – email is preferable.NOTE: without the referral you will not receive any Medicare rebate.

IMPORTANT !! No personal information is kept on this site as your completed form is transmitted to your Doctor’s secretary as soon as you have completed the form and given the ok for it to be transmitted.  We urge all our users to read the WTSC Web Privacy Policy prior to continuing..

PLEASE HAVE THE FOLLOWING INFORMATION READY BEFORE YOU START THE NEXT PAGE

  1. The login code provided to you by the staff at the time you made your consultation appointment
  2. Your Medicare Card
  3. Your private Health Insurance details (what level hospital cover, what excess you have)
  4. Your Medical History  (illnesses and surgeries)
  5. Your current Medications  (including dosage and time)
  6. Your referring Practitioner (including any other treating specialists)

IF YOU ARE READY NOW ENTER THE LOGIN CODE HERE

OR

ALTERNATIVELY YOU CAN DOWNLOAD A PDF FORM TO COMPLETE MANUALLY, SCAN AND SEND BACK VIA EMAIL  – IF YOU WISH TO DO THIS PLEASE ENTER YOUR LOGIN CODE HERE