Unit 75, Level 4, Wexford Medical Centre
3 Barry Marshall Parade, Murdoch, WA 6150
Phone : (08) 6389 0631 | Fax : (08) 6313 0613
info@coastalgastro.com.au

Electronic Enquiry Form

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Last Name
First Name
Date of Birth
Telephone Number
Nature of Enquiry
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You can only request an appointment if you have a valid referral to one of the doctors in this practice. If you do not have a referral please go and see your GP.

We would prefer to send some of our communications with you via email or text message for convenience and environmental reasons. However, email is not considered secure despite the alternative, Australia Post, not being secure either. We therefore need your consent for this. We will never pass your email to other parties and will only use it for appointments, clinical information and clinical reminders when absolutely necessary.

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