Estimate of Fees

You are encouraged to use the form below to receive an estimate of your anaesthetic fee. Please see our important explanatory note for information you need to be aware of.

We will endeavour to respond to your request within 2 working days. Please indicate any preference for method of communication.

Estimate of fees request form

Name*
Date of birth*
DD slash MM slash YYYY
Address*
Street Address Address Line 2 Suburb Postcode
Phone number*
Contact email*
Anaesthetist (if known)
Surgeon*
Operation type*
Expected operation date (if known)
DD slash MM slash YYYY
Hospital (if known)
Health fund
Health fund membership
Comments
Pensioner?
- Yes
- No
Name
This field is for validation purposes and should be left unchanged.