Circumcision Brisbane

Gentle Procedures Clinic Online Registration

We request the relevant registration form be completed a minimum of 48 hours before an appointment in order to allow the doctor to review the medical records.

GentiCare Payment Plan Application Form

For all enquiries relating to a Circumcision please complete all fields below.

Gentle Procedures Clinic Queensland Registration Templates

Child Registration Templates (00 to 15 Years of Age)

  • It is important to know details about a patient’s medical history as this forms part of vital medical records. 
  • We kindly ask you complete the form 48 hours before your appointment as this allows adequate time for the doctor to review these records prior to the appointment. 
  • All fields are mandatory, if you do not have the  information please enter n/a for not applicable or for a field with numbers enter 0
  • Click on the relevant link below & allow 10 minutes to complete the form. You will need your Medicare card details.
  • If your child is under the care of a specialist, midwife or hospital please arrange a referral letter outlining the medical history and documentation demonstrating it is safe for your son to have the Circumcision.
  • All Parents are required to digitally sign the form. If one parent cannot attend that parent needs to complete the non-attending consent form.
  • You will need your son’s Medicare details, medical history, medications and allergies.

CHILD CIRCUMCISION REGISTRATION

NON-ATTENDING PARENT REGISTRATION

Adult Registration Templates (15 + Years of Age)

  • It is important to know details about your medical history as it forms part of vital medical records.
  • Please complete the relevant registration below a minimum of 48 hours before your appointment.
  • This allows adequate time for the doctor to review these records prior to your appointment.
  • If you are under the care of a specialist please arrange a referral letter.
  • If you are taking blood thinners please see your GP and advise you are required to cease them for the procedure, please ask your treating doctor to arrange a referral letter.
  • All fields are mandatory, if you do not have the  information on hand please enter n/a for not applicable.

ADULT CIRCUMCISION REGISTRATION

VASECTOMY REGISTRATION

PENILE FRENULECTOMY REGISTRATION

DORSAL SLIT REGISTRATION

CIRCUMCISION REVISION REGISTRATION

CONSULTATION online REGISTRATION

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