Where did you hear about Enriched Health Care?
Participant's residential address (street, suburb, postcode)
Please provide mobile phone number where available. This ensures that your participant can be contacted during their time with us. Format: (0x) xxxx xxxx; Ex: 0450 480 308
PLEASE DO NOT ENTER A REFERRER EMAIL OR ALTERNATE EMAIL INTO THIS FIELD AS IT WILL AFFECT YOUR PARTICIPANT'S INFORMATION. Enriched Health Care requires an email address for the participant. We will use this email address to set the participant up in our system and to communicate with the participant. Participants include Job Seekers, Injured Workers, NDIS participants, Aged Care patients, athletes, and all other patients.
Accepted condition through claim and funding
Please provide fax number if General Practitioner has no email
eg: Orthopaedic Surgeon, Neurologist, Psychologist...
Please provide fax number if specialist has no email
eg: Physiotherapist, Occupational Therapist, Hand Therapist...
Please enter any additional details of your request and attach any relevant documents. A member of our support team will respond to your request as soon as possible.