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Mon-Fri 8:30am-6:00pm | Sat 9:00am-4:00pm | Sun 10:00am-4:00pm
(03) 4216 6868
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The Quay Family Healthcare
The Quay Family Healthcare
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BOOK AN APPOINTMENT
  • Home
  • About Us
    • Mission
    • Privacy
    • Team
    • Fees
  • Our Doctors
  • Services
  • Allied Health
  • Dental
  • Contact Us

Patient Registration

Step 1 of 4

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Patient Details

DD slash MM slash YYYY

Next of Kin

Emergency Contact

Do you identify as someone from a culturally and/or linguistic diverse background?*
To assist with health initiatives - are you Aboriginal or Torres Strait Islander?*

Health Questionnaire

Allergy to medication or food?*
Smoker Status*
Alcohol Intake*
If yes, please choose standard drinks/per*
Recreational Drugs*
Regular Medications*
If yes, Please list below any medications and their doses if known – include over the counter medications and supplements*
Current/Previous Medical Conditions*
If yes, please tick any that apply*
Family Medical History*
If yes, Please list below*
Relation to you (e.g., mother, grandfather, sibling)
Condition/s
 
Our practice undertakes research, professional development, and quality assurance/improvement activities to improve patient care. All people accessing personal health information for this purpose have signed a written confidentiality agreement.
I consent to my health record being reviewed and uploaded to My eHealth Record as a part of the quality improvement activities in this practice.*
I give permission for my personal information to be collected, used and disclosed as described in this practice policy. I understand only my relevant personal information will be provided to allow the above actions to be undertaken and I am free to withdraw, alter or restrict my consent at any time by notifying this practice in writing.*
Our practice uses a reminder system to improve the quality of your health care. The practice sends reminders by mail or telephone for procedures such as vaccinations, pap smears and other health reviews.*
I consent to being contacted with reminders by sms/phone/email*

Book Your Appointments Now!

You can book an appointment by phone on (03) 4216 6868 or online.
If you would like to register as a new patient online you can do that here as well.

REGISTER HERE
BOOK YOUR APPOINTMENTS

The Quay Family Healthcare provides quality services and excellent patient centred care. Your health is our priority.

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We acknowledge the traditional custodians of the land on which we operate and pay our respects to elder’s past, present and emerging.

CONTACT INFO
  • (03) 4216 6868
  • (03) 8679 4444
  • The Dunes, T13, 222 Fischer Street,
    Torquay, VIC, 3228
  • info@tqfhc.com.au
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OPENING HOURS
Monday 8:30 AM – 6:00 PM
Tuesday 8:30 AM – 6:00 PM
Wednesday 8:30 AM – 6:00 PM
Thursday 8:30 AM – 6:00 PM
Friday 8:30 AM – 6:00 PM
Saturday 9:00 AM – 4:00 PM
Sunday 10:00 AM – 4:00 PM
Open some public holidays
REGISTER HERE
BOOK YOUR APPOINTMENTS
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