Step 1

What do you wish to speak to your Partner Practitioner about today?

Please note that for every consultation you will only be able to discuss a single issue.

Prescriptions
Documents and Referrals
Conditions
Other
Please select a single issue.
2 out of 5 steps complete

Tell your Partner Doctor more

What concerns do you have about your health?
Please provide at least 20 words.

20 words minimum.

Optional file upload (Photos, Scans, Reports, etc)
3 out of 5 steps complete

Contact Details

Please double check the information is accurate to ensure a seamless process.

Please enter a valid email address.
Email addresses do not match.
Please enter a valid mobile number.
Mobile numbers do not match.
4 out of 5 steps complete

Your information

This information is needed to confirm your identity and to be included on any documents your Partner Doctor provides.

Please enter your first name.
Please enter your last name.
Gender
Please select gender.
Please enter your street address.
Please enter a valid postal code.
▼
This field will be auto-filled based on your postal code.
Please enter a correct postcode to get the suburb.
This field will be auto-filled based on your postal code.
Please enter a correct postcode to get the state.
5 out of 5 steps complete

Medicare Details

Required for receiving a prescription.

Description of Image
Cross Icon I don't have Medicare

Review your details!

Please double-check your details below. This will be included on any documents provided by your Partner Doctor and cannot be edited after submission.