For our Patient Registration Form 

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either

 click here 

 or  scan this QR code:  

 

Please complete this form at your earliest opportunity

and at least a week ahead of your rooms appointment

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Do you wish to be placed on a cancellation list for a rooms appointment?

If so, please asap complete this form,

attach your referral and have any tests requested by your referring doctor; 

this will allow us to contact you quickly for an earlier appointment, should one become available. 

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We generally have a 4-5 week wait for appointments

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If you are seeing Dr Flanagan for the first time when you are in hospital,

kindly complete this form at your earliest convenience