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Patient Registration Form

Health Consultation Meeting
Date of Birth
Day
Month
Year
Gender Identity
Birth Sex
Preferred Pronoun
Residential Address
Is your Postal Address the same as above?
Yes
No
Do you require a translator?
Yes
No
Do you identify as Aboriginal?
Yes
No
Do you identify as Torres Strait Islander?
Yes
No
Do you have a Medicare card?
Yes
No
Concession Card (Leave Blank if Not)
HCC
Pension
Seniors
DVA (Gold)
DVA (White)
DVA (Orange)
Are You a Child Under 16
Yes
No

Children under 16 need to have an adult as the primary account holder (appearing on the same Medicare card) as Medicare will not accept claims for children.

Privacy Policy

View Street Medical complies with the Privacy Act (1988) and the Australia Privacy Principles (APP). As part of our Privacy Policy we are committed to protecting the privacy of individuals and their personal information. The primary purpose of collecting personal information is to provide quality medical and health related services and associated business processes (e.g. financial claims and payments, practice audits and accreditation). In providing these services it may be relevant to disclose personal information to;

  • other health providers for your continued care (e.g. medical or allied health providers, radiology, and pathology services, the Australian Immunisation Register and National Cancer Screening Registers)

  • to your employer/prospective employer, their authorised representative or their insurer in cases of a work-related consultation, with your informed consent.


A copy of our Privacy Policy is available on request or by clicking here.


We make every effort to keep records accurate and up to date, you have the right to access your personal information and you may ask to update and correct your personal information.


View Street Medical may participate in relevant research or data collection for statistical activities, population health monitoring, quality improvement and professional development. We will never share identifiable personal information without your informed consent and ensure all research activities are endorsed by an ethics committee, within the National Health and Medical Council guidelines and legislations. Patients may withdraw consent for View Street Medical to use and disclose personal information except when legal obligations must be met.

Practice Communication and Reminder Systems

We use a recall and reminder system to enable a systematic approach to health promotion and preventative care. This includes appointment reminders, results recall, immunisations, routine health screening, preventative activities or skin checks. Our methods for contacting patients include both letters and electronic means.

Would you like to Receive Appointment Reminders by SMS?
Yes
No
Would you like to receive clinical reminders, clinical communication, health awareness information by electronic means?
Yes
No

Non-attendance Fees

View Street Medical will issue an account fee to the equivalent of the cost of the consultation missed. This is where a person fails to attend an appoint on more than one occasion and/or provides less than 2 hours' notice of cancellation. Failing to provide notice of cancellation or not attending an appointment reduces the availability of appointments for other patients.

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We will always try to accommodate you with the doctor of your choice on your preferred date and time, however when this is not possible, we will offer you the option to see another doctor.

 

We acknowledge the Aboriginal and Torres Strait Islander peoples as the Traditional Owners of this country, and pay respect to their cultures, and to Elders both past and present.

Get in Touch

​​08 9227 0171

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Open Hours​

Monday to Friday: 8:00am to 6:00pm

Monday and Friday Telehealth appointments available between 6:00am - 8:00am​

Saturdays: 8:00am to 4:00pm​

Sundays: Closed

After Hours Locum Service:

Night Doctor (Private Billing): 1300 644 483

Dial A Doctor (Bulk Billing): 1300 030 030

Copyright © 2026 View Street Medical | All Rights Reserved | Privacy Policy | Hosted by Wix, Built by Altsolve

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