PhenixHealth website booking form

Appointment Booking

For existing bookings, please email bookings@phenixhealth.com.au.

Fee Schedule

Appointment type	Patient fee (upfront payment)	Gap/Out of pocket fee	Medicare Rebate*
New Appointment (Private - non Medicare card holders)	$55.00	n/a	n/a
New Appointment	$55.00	$19.30	$35.70

*Medicare rebates only available for consultations with NPs. GPs private billing only. Consultation with both a GP or a Nurse Practitioner who are able to provide you with a prescription, referral, medical certificates, radiology and pathology requests.

Preferred appointment date and time: *

Select a date for your

Would you like to book with a Nurse Practitioner(NP) or General Practitioner(GP)? *

Nurse Practitioner(NP)General Practitioner(GP)*

Are you an existing or new patient? *

New patientExisting patient

Medicare

Do you have a Medicare card? *

YesNo

Request Type

You must have a Medicare, DVA card or IHI # in order to receive an escript to your phone.

How would you prefer to receive your Telehealth consultation through? *

Video call Phone call

Reason for consult:

Patient Details

First name *

Last name *

Date of birth *

Are you able to communicate with the Healthcare professionals in English or do you require a translator? your first language?

YesNo

ATSI

AboriginalTorres Strait IslanderNone of the above

Patient Contact Details

Mobile phone *

Email *

Repeat Script

If you have are after a repeat script. Please provide details of the medication you are after.

S8 Medication: It is not possible for our Medical Practitioners to provide any S8 medications, please do not proceed to book a consultation if you are seeking such medication as your consultation fee with the Medical Practitioner will not be refunded.

Repeat script details

Consent

If eligible for Medicare, DVA or concessional billing do you give permission to bill? *

YesNo

If Bulk Billed, I assign my rights to the Healthcare professional who rendered the services. If eligible for a Mixed billed consultation a medicare rebate will be processed and deposited into your nominated bank account directly by Medicare. *

YesNo

We are committed to protecting your privacy and know it is important for you to understand how your information is handled.

In submitting the information contained in this form, you:

Consent to collection of personal information and Privacy Policy. *

I confirm I have read and acknowledge the Billing Policy. *

Acknowledge that your health practitioner will collect such information (including any personal or sensitive information), for the purposes of providing you with health services or enabling any related communications. *

Payment

Signature

I confirm that above information I have provided is true, complete and accurate. *

Signature

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Today's date

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Medicare

Request Type

Patient Details

Parent/carer details

Patient Contact Details

Health History (Enables the Healthcare professional to better assess you)

Repeat Script

Consent

Payment

Signature