Skip to content

FOREST LAKE LOCAL DOCTORS

Phone (07) 2111-9111 | Fax (07) 3607 2449 | 4/85 Joseph Banks Ave, Forest Lake, QLD 4078

Home
Our team
Career Opportunities
Contact
Forms / Policies
Feedback
Fees

Request and Consent - Transfer of Medical Records

Patient name *

First

Last

Date of Birth *

My medicare card number *

Previous medical clinic name *

Patient Consent *

This request and authorisation applies to: *

Patient agreement *

Continue to Submit, only if you agree to this medical transfer request.

Our medical practice is accredited by QPA
(Quality Practice Accredited)
Our practice meets strict standards set by the Royal College of General Practitioners (RACGP), acknowledging our commitment to quality general practice patient care.
Best Quality Medical Centre in Forest Lake.

Private Billing Medical Centre

TEL (07) 2111-9111

FAX (07) 3607 2449

admin@forestlakelocaldoctors.com.au

85 Joseph Banks Ave, Forest Lake, QLD

Forest Lake, Inala, Richlands, Doolandella, Pallara, Heathwood, Durack, Darra, Ellen Grove, Camira, Oxey, Corinda, Sherwood, Graceville, Springfield, Spring Lake, Gailes, Algester, Rocklea, Acacia Ridge etc.

Copyright ©2020 | Forest Lake Local Doctors | All rights Reserved