New Patient Information

Please down load the form, Print and fill out the new patient registration form and sent via post before you arrive, which can be downloaded below.

• POST : 12 Bulkara Street Wallsend NSW 2287
• HAND DELIVER to reception at 12 Bulkara Street Wallsend NSW 2287
• FAX to 02 4955 0542
• Please do not email your form. Email is not sufficiently secure to protect your privacy.
• If you unable send patient information well in advance, please arrive at least fifteen minutes early to your first appointment. This will give sufficient time to fill out forms and for reception to create your computer file.

Download & Print Form

or

Fill In Online form

    New Patient Information


    Do you Identify as:


    Would you like SMS reminders?
    I consent to receive email communications regarding my medical care  





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    EMERGENCY CONTACT




    "This email address is not regularly monitored and is not our preferred means of communication. There is a risk that important clinical information sent to this address may be missed or not picked up, particularly time critical information. In addition, we urge all patients to carefully consider the issue of security before sending medical information via unencrypted emails. The alternative methods for communicating clinical information are below, please do not use normal post for forwarding time critical information. We encourage patients to phone the practice or make an appointment to discuss clinical issues."