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Please fill in our pre-admission form and return it to the centre at least 2 weeks prior to your appointment.

You can either:

  • Come in to our centre to complete the form in person or;

  • Download the form and send it back to us, along with your referral letter,

       by email (, or fax (03 9590 0147)

Pre-admission is an important part of your care to ensure your safety and convenience at our centre, therefore we ask that you complete this form thoroughly. This information is used by our doctors to check that you are suitable to be a patient at our centre and that necessary precautions are taken to ensure your procedure is both safe and appropriate on the day.


Pre-Admission Phone Call
You may be contacted by phone prior to your procedure by our pre-admission staff.  If you are contacted:

  • Your medical history will be reviewed with you and admission and discharge details discussed.

  • Please take this opportunity to discuss any concerns regarding your admission​.

Pre-Admission Consultation Appointment 

You may be required to consult one of the doctors at our centre at least 1 week prior to your procedure if you have certain health conditions or if you are taking certain medications.​

Please advise our staff if you have any of the following health conditions or taking any of the following medications:​

  • Age 80 and above

  • BMI 38 and above (BMI calculator)

  • Heart disease / cardiovascular condition

  • Blood thinning or anticoagulant medications, such as Clopidogrel, Plavicor, Warfarin, Persantin, Asasantin, Prasugrel, Plavix, Eliquis, Xarelto, Pradaxa, Brilinta, Ticlid, Iscover, Piax etc.

  • Respiratory condition, especially Chronic Obstructive Airway Disease (COAD), Obstructive Sleep Apnoea

  • Diabetes requiring insulin or SGLT-2 inhibitors, such as Forxiga (Dapagliflozin), Invokana (Canagliflozin), Jardiance (Empaglifozin), Steglatro (Ertugliflozin), Xigduo XR, Jardiamet, Segluromet, Qtern, Glyxambi, Steglujan etc.

  • Other major health conditions, such as liver, kidney or metabolic conditions.

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