Patient Registration

To help us provide you with the best possible care, please fill out our patient registration form.

This information will be kept in your file and treated as confidential (see Privacy Policy)


Step 1

Patient Details


Mailing Address
Next of Kin
Emergency Contact

Step 2

Medical Information
Aged / Disability Pension
General Practitioner
Finance
Work Cover (if relevant)
TAC (if relevant)

Step 3

Medical history

To help us provide you with the best possible care please answer the following questions. This information will be kept in your file and treated as confidential (please see our privacy policy for more details )

Do you have or have you ever had any of the following?





















Surgical History
Allergies

Step 4

Current Medications







In the event any of the details on this form changes I acknowledge that I will advise LapSurgery Australia so that my records are kept up to date

PLEASE NOTE THAT WE DO NOT BULK BILL

right-bar-logo
The team at LAPSurgery Australia are recognised for their exceptional and major contribution to the Government sponsored Bariatric Safety Registry (BSR). The BSR tracks surgical complications and provides an unbiased safety record for weight loss surgery.

BMI Calculator

Calculate your BMI online

Our BMI calculator will alert you if you are at risk of medical problems.

bmi-icon
Join Our Mailing List
Follow Us On Social Media For News And Events :