Request an Appointment for Neurology Network Melbourne

Fill out the form below

Name

First

Last

Attach your referral here (pdf preferred)

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Allowed file types: PDF, DOC, DOCX, JPG, PNG. You may attach multiple files if needed.

Phone

(mobile preferred)

Date of Birth

Address

Reason for Referral (optional)

For administration only. This will not be seen by your doctor so please do NOT request medical advice here. 500 characters maximum

Location (required)

Birth Reason Phone

Preferred Time

Preferred Specialist

Call 03 9500 8366

Fax: 03 8679 3341

Appointments for each neurologist, neuropsychologist or specialist can be made by calling our central inquiries number.

8.30am to 5.00pm Monday to Friday

(except public holidays)