Access to health records

Please note applications for access to health records may take up to 45 calendar days to be processed. If your matter is urgent, please contact us on 02 9715 5007 to discuss your circumstances.
Applicant details

The applicant is the person to whom the health information pertains
Full Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Address*

Street Address

Street Address Line 2

SuburbState

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
please provide the email address you wish to receive your records at
Consultation reportOther
Please provide details of the record(s) you are requesting*
E.g. date of consultation for consultation reports
Applicant Signature*
Should be Empty:

Applicant details