Appointment Request

Online Booking Request

We strive to make booking your appointment straightforward and efficient. Our experienced team is available to guide you through the process and ensure the appropriate examination is scheduled in line with your referral.

Please note that submitting an online booking request does not automatically confirm your appointment. A member of our bookings team will contact you to confirm availability and finalise the details.

If you would prefer immediate assistance, please feel free to contact our clinic directly, our team will be happy to help.

First Name

Last Name

Date of Birth (DD/MM/YYYY)

Gender

Is your appointment related to a workplace injury?

Yes No

Service

Date - first preference (DD/MM/YYYY)

Time - first preference

Date - second preference (DD/MM/YYYY)

Time - second preference

Phone number

Email address

Copy of referral #1 (Scan or take a photo of your referral and upload it here)

Copy of referral #2 (Scan or take a photo of your referral and upload it here)

Other information

By submitting this request, I understand that if I have flu-like symptoms on the day of my appointment, I will be required to reschedule.