Online Admission Form
Complete your online admission form.
Welcome to our secure online Pre-Admission Form. Here you can fill in your relevant details and complete your hospital Admission Form online, conveniently and confidentially.
How long will it take me?
This form should take you approximately 30 minutes to complete. If you have any problems completing the form, please contact [email protected]
What information do I need?
Please have the following information at hand when you fill in your online pre-Admission Form:
- Personal/next of kin details
- Medicare card
- Funding details (e.g. Private Health Insurance, DVA etc)
- Benefit details (e.g. pension card)
If you have any problems completing the form, please contact us via email to [email protected]
Acknowledgements
By completing this form, I acknowledge that I have read and understood the information contained within the following:
- Mayo Private Hospital Admission Information
- Private Patient's Hospital Charter
- Your right to privacy under the Privacy Act
- Informed Financial Consent
- Payment information
- Digital Consent Form (for surgeons)
I have read and understand my rights and responsibilities and how to make a compliment / complaint should I need to do so?
Click below to open the Online Admission form: