New Patient Registration Form

Please complete the form below and press submit. A member of our team will contact you if any further information is required prior to your appointment.

Your Contact Details

Next of Kin

Insurance Information

Referring Doctor

If the referring doctor is not your General Practitioner, please provide their details.

Tell us about your Condition


Medical History


Medical Checklist

Frequently Asked Questions

About The New Patient Registration Form

1. Do I need to complete the form before my appointment?

Yes, completing the form prior to your appointment helps ensure a smooth registration process and allows Dr Tulloch to prepare for your consultation.

If you are unsure about specific details, please provide as much information as possible. Our team can assist with any missing information.

Yes, if any of your details change or you need to provide additional information, please contact our clinic to update your records.

Yes, all information provided is stored securely and used only for the purposes of your care, in compliance with privacy laws and regulations.

Dr Scott Tulloch is committed to providing patient-centred care, and completing the New Patient Registration Form is an important first step in your treatment journey. By ensuring your information is accurate and complete, we can help deliver the highest standard of care tailored to your individual needs.