Patient Registration Form

  • Please complete the Patient Registration form and one of our friendly staff will contact you to confirm your details.
  • Patient Details

  • Parent/Guardian Details

  • Medical Details

  • Additional Information

  • Paeds in a pod aims to provide a comprehensive multidisciplinary service. Filling out this form will ensure that we can optimise the time we spend discussing the important issues you identify. We will keep all this information strictly confidential. You can download and print this form and email or fax the completed form to (07) 31772001 or email
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How Can we Help?

Our mission is to provide comprehensive medical care with best practice standards and modern expertise.

CALL 07 3177 2000


We have a number of locations around Brisbane to help make it easier for you to find us!