For our Patient Registration Form 

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either

 click here 

 or  scan this QR code:  

 

Please complete this form at your earliest opportunity

and at least a week ahead of your rooms appointment

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Do you wish to be placed on a cancellation list for a rooms appointment?

If so, please asap complete this form,

attach your referral and have any tests requested by your referring doctor; 

this will allow us to contact you quickly for an earlier appointment, should one become available. 

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We generally have a 4-5 week wait for appointments

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If you are seeing Dr Flanagan for the first time when you are in hospital, and your surgeon has asked you to

complete this form, kindly do so at your earliest convenience