|
Thank you for choosing Warringal Private Hospital.
Please ensure the Doctors consent & Referral form is forwarded to the hospital promptly in order to confirm your admission.
In order to ensure your admission is streamlined, we request that you complete this hospital admission form prior to your admission date.
You will need approximately 15 minutes to fill in this form. Some of the fields are mandatory and are marked with an asterisk (*). Much of the information required in this form is dictated by Commonwealth or State legislation or is required by the health funds.
To assist you with this process, please have the following information at hand:
- Personal/Next of Kin details
- Medicare Card
- Funding details (eg DVA, Private health insurance, workcover or self funding)
- Benefit details (eg pharmacy benefit card or pension card)
- Item numbers if these were quoted by doctors’ rooms
- Information your doctor supplied to you re implantable medical devices (eg prosthetic and disposables) – If applicable
- Medication information
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.
If you have any concerns or queries through the process please email us at:
onlinepread.WRP@ramsayhealth.com.au
or phone on 03 9274 1378.
To proceed, click the “Start New Form” button below.
|
|
|
|
|
| Already have a password & reference number? |
| Retrieve your form by filling out the fields below. |
|
|
|
|
|
|