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    Title/Salutation (required)

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    Home phone number (mobile preferred)

    Occupation

    Referring Doctor

    Referring Doctor Address

    Name of GP (if different from referring doctor)

    Address or Suburb of GP (if different from referring doctor)

    Who is responsible for account payment?

    Medicare Number (required)

    Medicare Ref Number (required)

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    Are your bank details registered with Medicare?

    Is this referral related to a WorkCover or TAC claim? (required)

    If "Yes" what is the TAC/WorkCover Claim Number?

    Private Health Insurer

    Private Health Number

    Are you on a Full Pension?
    NoYes

    Are you on a Part Pension?
    NoYes

    Pension Number

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    I have read and accept the fee statement outlined on this page (required)

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    I will notify staff if correspondence regarding my personal and medical information should not be sent via email (required)

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    Privacy Policy

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    Doctor’s Fee Statement

    Prof Christopher Bladin

    Please Note: This practice does not Bulk Bill

    Consultation Item Numbers & Service Fees:

    Item 132: Complex Initial Consultation (45 mins)

    Standard Fee $665

    Medicare Rebate (approx) $234

    Item 110: Initial Consultation

    Standard Fee $390

    Medicare Rebate (approx) $134

    Item 133: Complex Review Consultation (20 mins)

    Standard Fee $330

    Medicare Rebate (approx) $117

    Item 116: Review Consultation

    Standard Fee $250

    Medicare Rebate (approx) $67

    Prof Bladin does not provide consulting services for WorkCover or TAC insured patients.

    Please note that these fees are reviewed on July 1st each year. Patients with financial difficulties should bring their circumstances to the attention of the staff or the doctor. Accounts referred to a collection agent or solicitor will have all legal costs and commission added to the amount due.