Get Au Square Medical Centre New Patient Registration Form 2015-2025

Completing the AU Square Medical Centre New Patient Registration Form online is an essential step for new patients seeking healthcare services. This guide will provide you with clear, step-by-step instructions to ensure your registration process is smooth and efficient.

Follow the steps to complete your registration form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the patient information section. Enter your surname and given name in their respective fields. Select your gender and title (Mr, Mrs, Miss, Ms) as applicable. Provide your date of birth, followed by your street address, suburb, state, and postcode.
3. Next, provide your contact information. Include your home phone, mobile phone, and work phone numbers. Indicate your marital status and occupation. Also, mention your country of birth.
4. Answer whether you identify as an Aboriginal or Torres Strait Islander and list any other languages you speak. Additionally, provide your email address and choose if you would like to sign up for the mailing list by selecting 'Yes' or 'No'.
5. In the emergency contact information section, enter the name of your emergency contact, their relationship to you, and their contact number.
6. For Medicare details, input your Medicare number, the number on your card, and the expiry date. Specify the type of concession and its expiry date if applicable.
7. In the concession card details section, enter your concession card number.
8. Provide your medical information. Indicate if you have any allergies, and if none, specify 'Nil Known'. Continue by filling out the family history, current medication, and medical history sections. If you have no significant history, you can also indicate that.
9. Answer if you smoke and if so, indicate how many cigarettes you smoke per day. Additionally, state if you drink alcohol, and specify how many days per week and how many glasses per day.
10. Finally, sign the form, indicating that you consent to the Square Medical Centre collecting, sharing, and receiving information related to your medical care. Include the date of signing.
11. After completing all sections of the form, you may save changes, download, print, or share the form as needed.

Start filling out your AU Square Medical Centre New Patient Registration Form online now to ensure your registration is completed efficiently.