If you are a new patient
- Tele Health
- Tele Health
- Tele Health
- Tele Health
- Tele Health
A
Have you travelled overseas in the last 14 days ?
If it has been more than 14 days since you travelled through any overseas countries, answer 'No'.
Have you travelled overseas in the last 14 days ?
Have you been in close contact with someone who has travelled overseas in the last 14 days ?
If it has been more than 14 days since you travelled through any overseas countries, answer 'No'.
Have you been in contact with someone who has travelled overseas
B
Have you been in close contact with someone with a confirmed case of coronavirus (COVID-19)?
In this instance, close contact refers to:
Have you been in close contact with someone with COVID-19?
C
Are you currently experiencing any of the following symptoms:
Are you experiencing any of the following symptoms?
E
Based on your responses, you might consider taking the following actions to minimise the risk of spreading the coronavirus (COVID-19) to others:
If you are an existing patient for telehealth consult, Please fill
First Name
Last Name
Contact Number
If you are a new patient, Proceed...
F
Name
Date Of Birth
Sex
Medicare Number
Phone Number
Allergies
Present Illness
Past Medical History
Current Medications
Do you have any of the below conditions ?
