FORM – New Patient


1. Please complete this form prior to your appointment

2. Submit Form

– Should you have any problems please ask at reception or call us on 82404577


NON ATTENDANCE FEES - Late cancellation with less than 12 hours notice or non attendance maybe billed.

ACCOUNTS are to be finalised on the day of treatment unless prior approval has been confirmed with Select Health Group.

I have read and understood the Terms and Conditions in the attached

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