Book Appointment

1
Have you seen one of our practitioners before? (In person or via Telehealth)* This field is required.If you've had an appointment with Restorative Health Clinic in the past—either in person or via Telehealth—please select YES. Otherwise, choose NO.
YESNO
2
Who did you see at your last appointment?* This field is required.Choosing the same practitioner helps us ensure continuity of care and the best possible outcomes.
Kate Ternahan
Michaela Walters
Tina Crosbie
Melissa Hadley Barrett
Cindy Owen
Tricia Thomas-Gabbett (QLD)
3
Would you prefer the next available appointment within a week?* This field is required.Please note: wait times to see Melissa may be up to eight weeks. To ensure timely access to care, she has personally trained three additional Men’s Health and Urology Nurse Practitioners—Kate, Michaela, Tina, Cindy and Tricia — who are available within a week.
Yes, I’d like the next available appointment with another Nurse Practitioner.
No, I’d prefer to wait up to eight weeks for an appointment with Melissa.
4
What’s your full name?* This field is required.We’ll use this to personalise your care and confirm your appointment details.
First Name
Last Name
5
What’s your date of birth?* This field is required.Your age helps our practitioners tailor your care based on your health stage and medical needs.
Date
Day
Month
Year
6
What’s your email address?* This field is required.We’ll send your appointment confirmation and important health updates to this address.
example@example.com
7
What’s your mobile number?* This field is required.We’ll use your mobile number to confirm your appointment and send secure SMS updates if needed.
Area Code
Phone Number
8
What’s your address?* This field is required.We need this to send prescriptions and tailor your care based on your location.
Street Address
Street Address Line 2
City
State
Zip Code
Australia
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Afghanistan
Albania
Algeria
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Angola
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Antigua and Barbuda
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Australia
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The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
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Canada
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Finland
France
French Polynesia
Gabon
The Gambia
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Ghana
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Mali
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Mayotte
Mexico
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Moldova
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Mongolia
Montenegro
Montserrat
Morocco
Mozambique
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Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
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Panama
Papua New Guinea
Paraguay
Peru
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Poland
Portugal
Puerto Rico
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Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
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eSwatini
Sweden
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Syria
Taiwan
Tajikistan
Tanzania
Thailand
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Tonga
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Turkey
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Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
9
What men’s health concerns would you like support with?* This field is required.If you’re unsure or your concern isn’t listed, please choose “Other.” You can tell us more later.
Erectile Dysfunction
Premature Ejaculation
Prostate Health
Peyronie's Disease
Bladder Health
Reduced Sex Drive
Testosterone deficiency
Sexual Transmitted Infection (STI)
Painful sex
Other
10
Have you had any treatment for this issue before?* This field is required.This helps your practitioner understand what’s been tried already—and what has or hasn’t worked for you in the past.
YESNO
11
Tell us more about your concern* This field is required.The more detail you provide, the better we can personalise your care and prepare for your appointment.
Include any symptoms, when they started, and how they’re affecting your quality of life.
12
How would you like to have your appointment?* This field is required.Choose between a confidential in-person appointment at our Murdoch, Vasse, Albany or Noosa clinics, or a secure Telehealth video call or phone call from the comfort of your home or office.
In-personTelehealth
13
Which region of Australia do you live in?* This field is required.This helps us match you to the most convenient in-person clinic or Telehealth option.
Perth Metro WA (Murdoch clinic)
South West WA (Vasse clinic)
Great Southern WA (Albany clinic)
South East QLD (Noosa clinic)
Elsewhere in Australia (Telehealth only)
14
How would you prefer we contact you to schedule your appointment?* This field is required.We’ll use your selected contact method to confirm the date and time.
PhoneEmail
15
Medicare Card InformationIf you have a valid Medicare card, please enter your details below. This helps us process eligible rebates after your appointment and keep your records up to date in our secure system. Medicare advises to allow 2-3 business for rebates to appear in your allocated bank account.
Card Number
Expiry Date
16
My Products* This field is required.Payment is required to finalise your booking. Once payment is received, our admin team will contact you within two business days to schedule your appointment based on practitioner availability. Cancellation Policy: Cancel 24+ hours before your appointment – full refund Cancel within 24 hours – $90 fee Cancel within 12 hours – no refund By proceeding, you confirm you’ve read and agreed to this policy. Your payment is processed securely using encrypted technology via Stripe.
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ORDER SUMMARY
Total costAUD
Initial Appointment
$240AUDEdit
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Follow Up Appointment
$180AUDEdit
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First Name
Last Name
17
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