• City Clinic
    Secured Booking Form
    Please complete all questions.

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  • Are you an existing patient of City Clinic?*

  • If your details have not changed since your last appointment we only need your mobile phone number to process your appointment request.

  • After you make your appointment we will take you to our patient data change form so you can update your patient file. This will only take a minute. 

    To make this appointment we still only need your mobile number unless that has also changed.

  • Mobile Changed?*

  • As your mobile has changed we will need your name to locate your patient file, your new mobile and your preferred e-mail address.

  • Preferred location for your appointment?*
  • Your preferred location for your appointment*
  • Preferred day for your appointment - Closed Public Holidays*
  • Your preferred time period for your appointment*
  • When should we contact you to confirm your appointment?*
  • Should be Empty: