New Patient Enquiry Form

Please complete this form if you are interested in becoming a patient at Ballina Health Centre 
1st Consultation - $600
2nd Consultation - $600
    Please view the services menu for further information and pricing on each of the consultation types we offer
  • If entering a landline, please include the area code
    Please tick box to confirm you have read and understand this policy
  • Please be specific, if you were referred by a relative, friend or practitioner include their full name
phone (02) 6686 9199 | 32 tamar street, ballina