Get Patient Registration Form

Completing the Patient Registration Form online is a vital step to ensure a smooth admission process. This guide will help you navigate through each section of the form, providing clear instructions and support.

Follow the steps to successfully complete your Patient Registration Form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the 'Personal Details' section, fill in your surname, given name, and middle names as applicable. Indicate your gender by selecting the appropriate option, and provide your date of birth and age.
3. Enter your Medicare number and its expiry date. Make sure to include the number next to your name on your Medicare card.
4. Complete the 'Permanent Address' section with your street number or property name, street name, suburb or town, state, and postcode. Also, provide your home, business, and mobile telephone numbers.
5. Fill in your email address and information related to your country of birth and language spoken. Indicate if you require an interpreter.
6. Provide information about your marital status and religion. If you do not want your religion shared with the chaplaincy service, make sure to check the appropriate box.
7. For the 'General Practitioner / Local Doctor' section, include their surname, given name, address, and contact information.
8. Complete the 'Financial Details' section, including Centrelink number, private health fund membership, and preferences regarding private patient treatment.
9. If applicable, provide details related to Veterans' Affairs, worker’s compensation, and third-party liability claims.
10. Fill out the 'Person to Contact' and 'Next of Kin / Power of Attorney' sections with the necessary contact information.
11. Review all your entered information for accuracy. Once confirmed, you can save changes to your form, and initiate downloading, printing, or sharing as required.

Complete your Patient Registration Form online today for a streamlined admission process.