Forms
Patient Forms & Questionnaires
All forms and associated information can be found below. Please be sure to read all information carefully and bring the completed form to your appointment.
-
This practice is committed to providing patients with the best care. To do this, it is essential that your health record is kept up to date and accurate.
Please fill out the form associated with your practitioner linked below (otherwise please use the last form on the list) and bring it with you to your appointment:
Dr Talat Uppal - New Patient Registration Form
Penny Hanlon - New Patient Registration Form
Dr Anna Bolliger - Psychiatry New Patient Registration Form
Tracey Martin - New Patient Form
*These editable PDF forms can be filled out on the computer prior to printing for your convenience. Please save the form to your device first before editing.
-
If able to please complete and sign the applicable consent form for your out-patient/in-clinic procedure prior to your appointment:
Iron Infusions
Long Acting Reversible Contraception (LARC)
Out-Patient
*These editable PDF forms can be filled out on the computer prior to printing for your convenience. Please save the form to your device first before editing.
-
In order for the Gynaecologist to better understand your symptoms, please fill out the form below and bring it with you to your appointment:
Dr Talat Uppal:
*This form is an editable PDF and can be filled out on the computer prior to printing for your convenience. Please save to your device before editing.
-
In order for the Physiotherapist to better understand your symptoms, please fill out the questionnaire linked below and bring it with you to your appointment:
The Australian Pelvic Floor Questionnaire*
The Australian Pelvic Floor Questionnaire (APFQ) is one of the few validated questionnaires that integrate bladder, bowel, and sexual function as well as pelvic organ prolapse symptoms.
*These is an editable PDF form and can be filled out on the computer prior to printing for your convenience. Please save the form to your device first before editing.
-
Our anaesthetists aim to ensure that patients are as well prepared for their anaesthetic as is possible.
Please find associated forms below to be completed:
Dr Jane Li:
Dr Anna Pedersen:
-
Please find the consent form below. It is essential that this form is completed prior to your appointment.
For more information on medical terminations and unplanned pregnancy counselling, please click here.
-
In order for our clinicians to better understand your symptoms, please fill out the questionnaire linked below and bring it with you to your appointment:

