• Pulse Holistic Medical Centre

  • Request for Medical Records

  • Pulse Holistic Medical Centre Suite 1A, 68 Jessica Blvd Minyama Qld 4575

  • Dr Mark Fulton/ Dr Tracy Johns /Dr Nicole Nelson/ Danielle Roberts/Gina Wilson

  • Ph: 07 5477 5522 Fax 0754775599

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  • The above patients have recently come under the care of this surgery and have requested that a full/summary of records be forwarded to this surgery. Please forward any relevant records and immunisation history at your earliest convenience. Please do not send records on a disc. If applicable, could you please also advise the dates that any of the following have been billed:

  • GPMP (Items 721/723 or 732)

  • Health Asses (Item 707)

  • DMMR (Item 900)

  • Mental Health Plan (2715/2717 or 2712)

  • Yours Faithfully

  • I hereby authorise you to send my/our medical records to Pulse Specialist Medical Centre

    Signature of patients named above

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  • IMPORTANT NOTICE REGARDING CONFIDENTIALITY

  • The information in the facsimile message is intended for the sole confidential use of the designated recipients and may contain confidential information. If you have received this information in error, any review, dissemination, distribution or copying of this information is strictly prohibited. If you have received this communication in error, please notify us immediately by telephone.

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