Patient Registration

Patient Details

Date of Birth

Address

Parent / Guardian (Primary Contact)

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Referring Doctor Details

Your payment details are stored securely to facilitate efficient billing for future services, including Telehealth consultations, prescription requests, and medical reports.  A $0.50 verification charge will be applied to your nominated card to confirm the payment method. In accordance with our Appointments and Fees Policy, full payment is required on the day of service. For Telehealth, payments are processed in advance to secure your booking. See Appointment and Fees Policy

Consent

At Brighton Health Clinic for Kids, we believe clear and respectful communication is essential to your child's health and wellbeing. We value your trust and work closely with families when making decisions about care and information sharing. To provide the best possible care, relevant information may be requested or shared with other professionals involved in your child’s health, development, or education.

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