New Patient Forms

Click the link below to download and print a copy of our Patient Registration Form and Medical Information Form . You can fill this in and bring along to your scheduled appointment.

Patient Registration Form

Patient Medical Information Form

Transfer of Medical Records Form

If you register as a patient at Main Street Medical Centre, your records will need to be transferred from your previous doctor.  This form can be downloaded and given to reception staff on arrival.

Request for Medical Records Main Street Medical Centre

Leaving Main Street Medical Centre, a request form will be required from your new doctor to have your records transferred.  A health summary will be forwarded free of charge and full records copied onto disk will incur a fee of $20.

Travel Assistance Form (IPTAAS)

IPTAAS is the Isolated Patients Travel and Accommodation Assistance Scheme. This is a NSW Government initiative designed to help with the financial assistance towards travel and accommodation costs when a patient needs to travel lengthy distances for specialist medical treatment that is not available locally.

http://www.enable.health.nsw.gov.au/services/iptaas 

 

Medical Confidentiality Release Form

For use to allow a third party (family member, carer etc) to access parts or all of a medical record.

Medical Confidentiality Release form

 

Personal Health Information Request Form

Personal Health Information Request Form