Bookings - Stigma Health

Full Name*

First Last

As per Medicare card or passport.

Date Of Birth*

Please enter to continue

Hidden

Age

Hidden

AgeCalc

Please Note: You must be 16 or older to use Stigma Health.

Gender as per Medicare*

Male
Female
Transgender

Do you identify your gender more specifically?*

No
Yes

We are inclusive and this service is for everyone. However, the nature of the medical referral process requires us to adhere to certain healthcare language guidelines that may not suit you. We hope you understand. We are doing our best and we want you to feel welcome here.

Gender indentity*

Address*

Address is a Medicare requirement. Nothing is sent.

Street Address Address Line 2 City State Postcode

Australian Mobile Number*

Your Australian mobile number.

Email*

This must be your email, no one elses.

Are you an Aboriginal or Torres Strait Islander?*

Yes
No
I would rather not say.

Do you have Medicare?*

Yes
No

Medicare details

Medicare card holders need to provide Medicare details, so we can bulk bill the appointment. Note invalid Medicare card holders will incurr a $85.00 fee for telehealth consults.

Medicare Card Number*

10 Numerical Digits

Individual Reference Number (IRN)*

Number in front of your name on the card.

Telehealth Consult Charge

No Medicare Consult.

Telehealth Consult Charge*

Price:

Confirmation

How did you hear about Stigma Health?

Please help us to get the word out there. Returning customers - if you remember how you hear about us tick that one!

Total

$ 0.00

Agreement*

I accept the Terms & Conditions of the Stigma Health service

Name

This field is for validation purposes and should be left unchanged.

Book Sexual Health Appointments

Booking details form

Medicare details

Telehealth Consult Charge

Confirmation