Skip to main content

Two Kidneys

For appointment
  • Phone : 02 4321 0555
  • Fax : 02 4321 0125
Make Appointment
Forms

Patient Forms

Complete Your Forms Online

Choose a form below – each takes only a few minutes and is sent securely to our rooms

Patient Information Form

New patients: your contact, GP, Medicare and health fund details, medications and a short kidney health questionnaire.

Start form

Consent & Practice Terms

Consent to the release and acquisition of medical information, and our practice terms & conditions.

Review & sign

Assignment of Benefit (DB4)

Medicare Bulk Bill Assignment of Benefit Agreement – sign before your appointment.

Sign agreement

AI Scribe Consent

Consent for Dr Kumar to use Lyrebird Health, a secure AI scribe, to help write your clinical notes.

Give consent