Download: New patient registration form - PBB Health Centre 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section A: Personal details. Fill in your title, surname, given names, and date of birth. Select your gender and marital status by placing an 'X' in the applicable boxes.
3. Provide information about your cultural background and language preferences. Indicate if you require an interpreter.
4. Enter your home and postal addresses, along with contact numbers including telephone, work, and mobile. Don’t forget to include your email address and Medicare card details.
5. In Section B: Allergies, list any allergies or intolerances along with their reactions. Document any regular medications you are taking.
6. Section C: Consent requires you to agree to receive health reminders via SMS or other methods. Sign and date the form at the bottom.
7. If applicable, complete Section E regarding the transfer of health information from previous healthcare providers.

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