Patient History

patient history - dr pontré

To ensure you get the most out of your appointment, and can maximise time spent discussing your issue with Dr Pontré, please complete this form prior to your appointment. Please note that you will be required to discuss these responses during your consult.

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 scan and email the completed form to

Patient History - Dr Pontré

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

Patient Authority to Release Medical Information to a Nominated Party