Terms & Conditions
- If patient has private health insurance the 10% is discounted before processing HICAPS. If patient does not have private health 10% is taken off total.
- All item numbers
There may be outstanding required fields that you need to answer before submitting your form. You should see each field that requires an answer in a red box at the bottom of your form. Once you have answered all fields, if a signature is required, you must sign your signature electronically using your mouse or fingers in the box provided.
If you are still unable to complete the form, you can fill out the form on paper at the clinic before your appointment.