GOOD BONES ORTHOPAEDICS LTD

Julian Stoddart

Request An Appointment

Required

Required

Submitting Form...

The server encountered an error.

Form received.

Required

Required

Required

Required

Required

Required

Required

Required

Required

Required

Required

Required

Required

Required

 

 

Patient details

 

 

 

 

We need to be able to contact the patient

 

Please select the preferred contact

PHONE 06 769 5634

© 2016 Good Bones Orthopaedics Ltd

 

We may need to send  information in the post

 

 

Very useful information if you can provide it

 

 

 

We may need to contact you for more information

 

 

 

 

 

This will help us plan the appointment

 

 

 

All patients require up to date x-rays (normally within the last 6 - 12 months)

 

If you are ACC patient your visit is paid for

 

 

 

 

We need these details if we are lodging claims for ACC

 

Complete These Questions For ACC Case's Otherwise Leave Blank

 

Knowing if the patient is insured helps us with administration

 

We appreciate referral letters sent ASAP. We would rather have a slightly older letter than a late up to date one.

 

Pre-appointment scans can only be made after we have the referral letter

 

 

We need to check you are a real person and not a robot!