Appointment Form

This is a secure website. Information you provide will not be accessed from the internet by anyone. It will be printed at our office and stored on your file confidentially. Our secretary or nurse will contact you to finalise your appointment.

If your doctor has given you a referral letter please deliver or mail this to Suite A5, Canberra Specialist Centre, 161 Strickland Crescent Deakin ACT 2600, or fax to 02 6162 1313, or email to [email protected].

Your Details

 

I wish to make an appointment

 

Nurse Pre-Admission Clinic - Confidential medical information

 

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