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New Patient Registration Form

New patients that would like to arrange a geriatrician consult can fill in the below form online or print the form here.

Patient Information


Next of Kin Contact Details

GP Information (referral required to book new patients)

Upload a GP referral or email to, or a GP can complete online here

Upload File


Geriatric Care Australia collects information for the primary purpose of providing quality healthcare. We ask for personal details and a full medical history so that we may properly assess, diagnose and treat illnesses and be pro-active in healthcare delivery. We will also collect, hold, use and disclose the information you provide in accordance with the Privacy Act 1988 and Australian Privacy Principles (March 2014).

Thank you for submitting, the team will be in contact.

Reminder: Every new patient appointment requires a Referral from a GP, which can be emailed to or completed by a GP online here

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