Patient Referral

For Doctors: Please use the healthlink code: childhub

Application Form (All fields are required)

Patient's Name

Date of Birth

Has your child attended our clinic before?

Yes No

Parent or guardian's name

Phone number

Brief purpose of referral

Please upload the referral letter provided by the referring doctor

If you do not hear from us within 3 business days, please follow up with a phone call 02 8528 2532 or email info@chhub.com.au, in case of technical difficulties.

Patient Referral

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