🌿 Curatd Health

Clinic Referral Information

Complete this form and our team will contact you to arrange your appointment.

Prefer to book by phone? Call 07 3180 6750.

If you are a new patient to the clinic you will also need to complete the online patient consent form and pre-screening intake form. All required forms must be completed prior to your appointment.

Patient Full Name *

Please use your legal name

Patient D.O.B * Patient Email Address * Patient Phone Number *

Mobile preferred, e.g. 0400 000 000

Anything else you'd like the clinic to know? (optional)

Submitted securely to Curatd Health for follow-up.

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Referral received

Thanks — we have your details. Our team will be in touch to arrange your appointment with the next available doctor.

New patients: you'll also complete a consent and pre-screening form before your appointment.