In order to confirm your appointment we do request a complete medical history on the person having a procedure with Gentle Procedures Clinic Queensland, please complete all fields. All information provided is confidential and will be handled in accordance with our Privacy Policy. We appreciate your assistance and completing this as soon as possible.

By completing the electronic form and signing it electronically you are making an informed consent to the procedure being performed on the date of the appointment.

By completing and electronically signing for a child aged 00 – 14 years you are making an informed consent for the procedure to be performed on your child, and that you are the legal parent / guardian. For any person aged 15+ you must ensure you complete the form and that you have made an informed decision to have the procedure performed.

If you do not consent to any of the above or wish to discuss further with doctor do not complete the form and contact our office.

If you have any immediate questions, please call us at 07 2103 2322

Thanks for booking with us.

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