New Patients Welcome

New Patient Registration

Register with Sunrise Family Medical Centre online — no appointment required. Complete the form below and our reception team will have your details ready before your first visit.

Prefer to book straight away? Visit our New Patients page.

Your details

First name *

Last name *

Preferred name

Date of birth *

Gender

Contact details

Email *

Mobile number *

Home phone

Residential address

Street address

Suburb

State

Postcode

Medicare & concession

Optional, but adding these now speeds up your first visit.

Medicare number

Ref / position no.

Expiry (MM/YY)

Concession / Healthcare / DVA card

Emergency contact

Name

Phone

Relationship

Medical background

Optional — share anything helpful for your first appointment.

Existing medical conditions

Current medications

Allergies

A few last things

Preferred doctor (if any)

How did you hear about us?

Anything else you'd like us to know?

I'd like to receive occasional health tips and clinic updates by email.

I consent to Sunrise Family Medical Centre collecting my personal and health information to register me as a patient, as described in the Privacy Policy. *

Your information is sent securely to our reception team. For urgent medical concerns, please call us or attend the clinic — this form is not monitored in real time.