Request an Appointment

Complete the form below to receive a callback from one of our representatives confirming your appointment request. Alternatively, you can call 02 492 9000 or 800 AD HEALTH from 7:00AM to 10:00PM daily to speak to a representative.

If you have a medical emergency, call 999.


Requester Information

Who is this appointment for?



Patient Information

Please provide patient information as it appears on legal documents.

Have you previously received care at Healthpoint?



First Name:

Surname:

Country of Residence:

City:

Phone number:

Preferred callback time:




Email:

Gender:


Date of Birth:

Parent/Guardian name:

The name of a parent is required if
the patient is under the age of 16.


Medical Concern

What is the primary medical problem or diagnosis for the appointment request?


Important: After submission, please do not leave this form until you see the confirmation message.


Insurance Partners

We are a government-owned hospital and partner with multiple insurance companies to offer our patients health insurance coverage. Learn more about insurance and self-pay options at Healthpoint or contact us at 800 AD Health.