1300 188 988 | help@assessmedicalgroup.com.au

Make a booking

I would like an appointment between:
DD slash MM slash YYYY
DD slash MM slash YYYY
- OR the next available appointment
Location
Where would you like the appointment?
Specialty / Consultant
Specialty*
Doctor name
Claimant details
Full name*
Date of birth*
DD slash MM slash YYYY
Phone*
Date of injury*
DD slash MM slash YYYY
Address
Street name and number Postcode State Country
Referrer details
Full name*
Company*
Ref/Claim No*
Type of claim*
W.I.R.O. ILARS Ref No.
WIRO Grant Approved by
Phone*
Email*
Interpreter attending?*
- Yes
- No
ASSESS to book this interpreter?*
- Yes
- No
Language?
Email
This field is for validation purposes and should be left unchanged.