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First Name (on your Medicare card)

Last Name (on your Medicare card)

Mobile Number

Date of Birth (dd/mm/yyyy)

Gender Male Female Other

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Mobile Number

Email Address

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Mobile Email

Verification Code

Your current contact details

Street Address

Suburb

Post Code

Phone Number

Emergency contact details

First Name

Last Name

Phone Number

Relationship to patient

Next of kin contact details

Same as emergency contact.

First Name

Last Name

Phone Number

Relationship to patient

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Medicare Card

DVA Card

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Pensioner Card

Health Care Card

Note: If you do not hold any of the above cards please call Note: If you do not hold any of the above cards please go to the Reception.

Your Medicare details

Card Number (10 digits)

Line Number (1 digit)

Expiry Date (mm/yyyy)

Where can I find these details on my card

Your DVA details

Card Number

Where can I find these details on my card

And finally, your HCC details

Card Number

Expiry Date (mm/yyyy)

Where can I find these details on my card

And finally, your Pensioner details

Card Number

Expiry Date (mm/yyyy)

Where can I find these details on my card

Patient Details Summary

Address

Email

Emergency contact

Next of kin contact

Medicare

DVA

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Your current contact details

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Next of kin contact details

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Your Medicare details

Your DVA details

And finally, your HCC details

And finally, your Pensioner details

Patient Details Summary

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GP

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Is this a medical emergency?

Are you an existing patient?

Great, we'll need some details

Verify it's you

Your current contact details

Emergency contact details

Next of kin contact details

Thanks, now we’ll need your Medicare/DVA details

Your Medicare details

Your DVA details

And finally, your HCC details

And finally, your Pensioner details

Patient Details Summary

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Dr of your choice

Consultation Type

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