Ramsay Health Care - Health History & Assessment (Ver 6)

Your Health Portal
HOLLYWOOD PRIVATE HOSPITAL
Health History & Assessment

Thank you for choosing Hollywood Private Hospital.

Your health history is unique, and with this information gathered during the booking process our health professionals can tailor your care according to your individual needs before you attend our hospital.

Accurate health information is essential for us to provide the safest care and service possible. We request you complete this form prior to your admission date. Please be assured that if there are any concerns with your admission information, one of our staff will contact you, therefore in order to ensure your admission is streamlined and without complication please complete the questions to follow as soon as possible.

Once your admission to Hollywood Private Hospital has been confirmed with your admitting specialist, please fill in our online admission form.

You will need approximately 15 minutes to fill in this form.

When you click “Start New Form” you will receive a reference number and password (see example below)

Example Only

Please record this reference number and password when you receive it, somewhere secure as it will allow you to retrieve your information if you do not finish the admission form in one go.

This reference number and password can also be used in the future if you need to be readmitted to our hospital. By using this reference number and password in the future, any subsequent forms that you are required to fill in for admission to our hospital will automatically populate with the information you have provided us and only prompt you for new information, thus saving you time. If you lose the reference number and password you will have to start a new form.

When you have completed filling in your admission form, you will be prompted to ensure your details are correct before continuing. Once you are comfortable that the information you have provided is correct please press submit.

You will receive an automatic reply to confirm that it has been received by the hospital as well as a form identification number which you should keep available.

If you have any concerns or queries through the process please contact us on bookings.HPH@ramsayhealth.com.au or (08) 9346 6451.

To proceed click the “Start New Form” button below.

Privacy – How will your information be used?
Ramsay Health Care is required to comply with the National Privacy Principles (NPPs) under the Privacy Act 1988 (Cth). The NPPs regulate how Ramsay may collect, use, disclose and store personal information and how individuals (such as Ramsay patients) may access and collect personal information which Ramsay holds about them. For further information on how Ramsay handles your personal information please see the full policy on our website: http://www.ramsayhealth.com.au/profile/privacy_policy.asp

Security of this online admission form
To ensure the confidential transmission of your personal information between your computer and our hospital website, all information is secured by 128-bit SSL encryption technology.

Already have a password & reference number?

Retrieve your form by filling out the fields below.

Reference number

Password

Retrieve Form

Privacy - how will your information be used?
For further information on how your information will be used click here

Security of this online admission form
To ensure the confidential transmission of your personal information between your computer and the Ramsay Health Care website, all information is secured by 128-bit SSL encryption technology

ABOUT SSL CERTIFICATES