Patient Forms

Patient Registration

Please complete our online patient registration form. This form is only to be completed by patients who have a confirmed upcoming appointment at our Practice. 

If you would prefer to complete a hard copy, you are able to download the form at the end of this page. If this is your preference, please ensure you either:

a) Scan and email the completed form to reception@leake.com.au for Dr Leake and Dr Pontré, or reception@karthigasu.com.au for Dr Karthigasu; or

b) Bring the completed hard copy form to your initial appointment. 

Patient Registration Form

Should you prefer to complete a hard copy of this registration form, please download via the appropriate link below and email a completed copy to our Rooms.

Dr Robyn Leake & Dr Jennifer Pontré

Dr Krish Karthigasu