Routine Appointment Request

If you are unable to speak to reception by phone, please use this form to submit a ROUTINE appointment request. This will be forwarded to the administrative team, who will book you a routine telephone appointment with an appropriate healthcare professional or advise on alternative access to appropriate care. The appointment may be up to 14 days in advance.

Consultation Request

First make sure this is not an emergency

DO NOT use this form for any medical emergencies, as your request will not be seen immediately
Please confirm you do not have any of the following symptoms:

  • Crushing chest pain and tightness
  • Signs of a stroke, such as the face may have dropped on one side, unable to smile, droopy eyelid, Arms – may not be able to lift both arms, and keep them there due weakness or numbness in one arm.Speech maybe slurred or garbled, or unable to talk.
  • Severe difficulty breathing
  • Heavy bleeding that won’t stop
  • Severe injuries
  • Feeling suicidal, wanting to harm yourself, or others
Do you have any of the above symptoms? *

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