Aged Care Booking Form

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Requests via Aged Care Bookings are available during the following times
Monday to Friday from 6pm until 8am next working day
Saturday from 12:00pm
Sunday and Public Holidays 24 hours

Doctor Consultation for Aged Care Facilities

AGED CARE FACILITY

Name of RACF/HOSTEL/GROUP HOME:
Address:
After hour contact number/instructions:
Door / Gate codes:
Name of RN for visit
Contact Number:

FIRST PATIENT

Full Name:
DOB:
Gender:
Patients General Practitioner :
Patients General Practitioner Number:
Patients/GP Medical Centre:
Medicare Number :
Ref:
DVA Gold Card number :
Level/Ward/Section :
Complaint / symptoms for doctors visit:
Special Patient Instructions:
If "Yes", please have these available on arrival.
Next of Kin Name :
Next of Kin Phone:

SECOND PATIENT

Full Name:
DOB:
Gender:
Patients General Practitioner :
Patients General Practitioner Number:
Patients/GP Medical Centre:
Medicare Number :
Ref:
DVA Gold Card number :
Level/Ward/Section :
Complaint / symptoms for doctors visit:
Special Patient Instructions:
If "Yes", please have these available on arrival.
Next of Kin Name :
Next of Kin Phone:

THIRD PATIENT

Full Name:
DOB:
Gender:
Patients General Practitioner :
Patients General Practitioner Number:
Patients/GP Medical Centre:
Medicare Number :
Ref:
DVA Gold Card number :
Level/Ward/Section :
Complaint / symptoms for doctors visit:
Special Patient Instructions:
If "Yes", please have these available on arrival.
Next of Kin Name :
Next of Kin Phone:

FOURTH PATIENT

Full Name:
DOB:
Gender:
Patients General Practitioner :
Patients General Practitioner Number:
Patients/GP Medical Centre:
Medicare Number :
Ref:
DVA Gold Card number :
Level/Ward/Section :
Complaint / symptoms for doctors visit:
Special Patient Instructions:
If "Yes", please have these available on arrival.
Next of Kin Name :
Next of Kin Phone:

MEDICAL EMERGENCIES REQUIRE IMMEDIATE MEDICAL ATTENTION REFER TO 000

Hours of operation:

Monday to Friday from 6pm to 6am

Saturday from 12pm

Sunday and Public Holidays 24 hours

FREQUENTLY ASKED QUESTIONS

About Sydmed Doctor Visits

IMPORTANT PATIENT INFORMATION

Download Multilingual Brochures

IMPORTANT DOCTOR INFORMATION

Download our Doctor Information Sheet

VIDEO CONSULTS INFORMATION

View Instructions

THE SUBURB ENTERED IS WITHIN OUR COVERAGE AREA.

DOWNLOAD OUR APP TO MAKE A BOOKING NO WAITING ON THE PHONE

PLEASE NOTE

UNFORTUNATELY THE SUBURB ENTERED IS NOT WITHIN OUR COVERAGE AREA.