Home > Appointment Request

Please use the form below to make your initial appointment at one of our locations or from your own home by selecting telehealth.

Our patient service team member will be in touch with you to complete the booking process. You can also request an appointment by calling our main booking office at 9329 4761.

You can read more about our booking process here.

    Patient Contact Details

    Additional Patient Information

    Date of birth*
    Referring doctor's name *
    Name of the referring clinic *
    Location *
    Do you have insurance? *
    Are you an overseas visitor or student? *
    Are you an existing Neuroaxis patient? *
    Do you require a telehealth appointment *
    Please prove you are human by selecting the Heart.