Forms

Patients of Dr Emmanuel Varipatis:

EXISTING PATIENT FORM FOR MEDICAL RECORD TRANSFER:

Mojo Klinik Medical Record Transfer Request (please right-click and download then print the form).

If you are an existing patient of Dr Varipatis at Nature Care Health, please fill out the Medical Record Transfer request.

Once you have completed the form, you will need to call Nature Care Health Reception on 02 9966 8666 to make payment of the $40 admin transfer fee and email the signed form to forms@naturecarehealth.com.au

Please note that the administrative fee applies for all Medical Record Transfers. This fee helps cover the time and processes involved in securely preparing and transferring your medical file including protecting your file in this process and ensuring the transfer meets the Australian medical and privacy standards. 

We will do our best to transfer your file in a timely manner, please allow up to 10 working days to be transferred.