New Patients

To save you time, you can fill in some of our required paperwork prior to your consultation. Either print out our forms and bring them in with you, or email them to us online using our secure email form.

Download Patient Details Form

Fax your completed forms to us at: 07 4041 2001 or bring them in with you for your consultation.

Send Your Patient Details Online

Your details are submitted to our server over a encrypted connection, which then sends an email to our staff. Once your details are entered into your secure file this email is deleted immediately. By submitting this form, you are agreeing to our Privacy Policy.

 Yes
 No
 Yes
 No
 Diet
 Tablets
 Insulin
 Yes
 No
 Yes
 No
 Yes
 No
 Wafarin
 Aspirin
 Clopidogrel
 Insulin
 Methotrexate
 Prednisolone
 Yes
 No
 Yes
 No
 Heart Attack or Stroke
 Had a Stent or Pacemaker inserted
 Yes
 No
 Yes
 No
 Yes
 No
 Husband
 Wife
 Partner
 Parents
 Friend
 Yes
 No
 Yes
 No
 Seated
 Standing
 Walking
 50/50
 Yes
 No
 Yes
 No
 Yes
 No