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Patient Registration

Patient Registration
Who Are You Registering For?
Patient Name
Patient Name
First
Last
Birth Gender
Which cannabinoids are you interested in discussing with our doctors?
How did you hear about us?
Once you click the "Submit" button below you will reveive an e-mail from info@chronicdoctors.com.au containing the information you have provided with links to the Chronic Doctors consent form and a template referral form for your GP.

Please complete the consent form and return it by e-mail to info@chronicdoctors.com.au (replying to the e-mail you receive and attacheing the completed form is the easiest way).

Then take the referral form to your GP to complete and return directley to us with your medical history. Your GP can also download it from our web site.

Once we have your consent form, your GP's referral and your Medical History we will contact you to arrange your initial telehealth consultation.

You can also download the forms here as fillable PDF's:

  • Consent Form
  • GP Referral Form