New Patient Registration | Melbourne Pain Group

Get ready for your first appointment

Complete your patient registration before attending Melbourne Pain Group. Providing your medical history, contact information & relevant details helps our specialists prepare for your consultation.

What You’ll Need

Please have the following information available:

  • Personal details & Medicare information
  • Current medications & relevant medical history
  • Referring doctor’s details
  • Private health insurance or WorkCover/TAC details, if applicable

Complete Your Registration

Complete your registration

Once your appointment is confirmed, please complete the registration form below. All information is handled in accordance with our patient privacy practices.

New Patient Registration

"*" indicates required fields

1Personal Details
2Contact Details
3Memberships
4Emergency Contact
5Medical Information
6Consent To Release Medical Information
This field is for validation purposes and should be left unchanged.
First Name*
Last Name*

Ready to take the next step?

  • Comprehensive pain assessments
  • Individual treatment planning
  • Medication review and optimisation

Request an appointment Contact our team

Melbourne Pain Group Glen Waverley Head Office Outside Photo