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Online Admission Form  

Pacific Day Surgery located in Fortitude Valley, Brisbane uses an online, cloud based program for admitting patients to our hospital for surgery.

The admission form will take about 5 minutes or less to complete online.  


You will need to have the following details handy. 

Date of Surgery, Health Insurance details, Medicare Number, Name, Address, Contact Details for yourself and your pick-up person (for General and Neurolept Sedation patients)

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 Complete the online form by clicking button below

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