Referral Form / GP or Self Referral

A vast majority of our patients use self funding payment plans or superannuation to finance their surgery. We help support you in this every step of the way.

Australian Data

We do see patients directly without a referral (PLEASE BE AWARE WE ENCOURAGE AND PREFER OUR PATIENTS TO SEE AND DISCUSS THIS DECISION WITH THEIR GP AND OBTAIN A REFERRAL)

We have a large amount of patients who see us from word of mouth with friends and family’s sharing their experience with them. If you would like to see us as a self referral 

You can use this online form (No medicare rebate is processable without a valid GP / Specialist referral )


Personal Details


Insurance Details


Concession Card


General Practitioner's Details


Referring Doctor


Next of Kin Details


Medical Questionnaire

Click or drag files to this area to upload.

You can upload up to 5 files. Max. file size: 25 MB.


Patients / Guardian / Medical power of Attorney Signature

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NB - don't include any sensitive medical information

Our Client Reviews

If you are thinking of this journey and would like to talk to one of our patients directly to get their perspective – Please feel free to contact us.