Manage an Appointment

Cancel an existing appointment using the form below. Fields marked with an asterisk (*) are mandatory.

If you need to reschedule or change your existing appointment, please call 1300 567 046 between 8am and 5pm
or (08) 9599 3998 for after hours assistance.

Manage an Appointment Form

URL
This field is for validation purposes and should be left unchanged.
Appointment request:*
Your Details
Title*
First Name*
Last Name*
Date of Birth*
Day
Month
Year
Contact Phone Number*
Email*
Enter Email Confirm Email

Your email is only used for appointment confirmation
‘New appointment’ requests will be responded to with a phone call.
‘Change existing appointment’ requests will be responded to with a phone call.
‘Cancel appointment’ requests will be responded to with an email.
Existing Appointment Information
Appointment Location*
Appointment Date*
Day
Month
Year
Appointment Time*

: Hours

Minutes

AM/PM
Reason for cancellation*
New Appointment Preferences
Appointment Date*
Day
Month
Year
Appointment time*
Your Referral
If you are unable to upload your referral, please call your preferred clinic. Contact numbers can be found on the Locations page.
Upload referrals*
Drop files here or

Accepted file types: jpg, pdf, png, jpeg, Max. file size: 32 MB.
Your Procedure
Procedure required*
Preferred branch*
Preferred time
Download MRI Procedure Screening Form

Patients who are having an MRI, please download and print out our MRI Procedure Screening Form, complete it and bring it to your appointment. If you answer 'Yes' to any of the questions, please contact us prior to your appointment to discuss.

Download form
Do you have a current Pension or Government Health Care Card?*
- No
- Yes
Do you have a current DVA card?*
- No
- Yes
Are you claiming Motor vehicle Accident or Workers Compensation?*
- No
- Yes
Comments

Manage an Appointment

Manage an Appointment Form

Your Details

Existing Appointment Information

New Appointment Preferences

Your Referral

Your Procedure

Download MRI Procedure Screening Form

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Manage an Appointment

Manage an Appointment Form

Your Details

Existing Appointment Information

New Appointment Preferences

Your Referral

Your Procedure

Download MRI Procedure Screening Form

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Quick Links

Website Policies

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