Patients of Dr Emmanuel Varipatis:
If you are an existing patient of Dr Varipatis, please click on the link below to download and print the ‘Medical Record Transfer’ Form.
Once you have completed and signed the form, please send it through to us at firstname.lastname@example.org
It is important to send it through asap so that we can ensure your records can be accessed at your next appointment.
EXISTING PATIENT: – Request for medical record transfer (please right-click and download if you would like to save a copy)
If you are a new patient and have made a booking with Dr Varipatis, please click below to download and fill out the ‘new patient questionnaire’.
Once completed, please send it through to us at email@example.com or bring it with you on the day of your first consultation.
NEW PATIENT: – NCH – New Patient Questions (please right-click and download if you would like to save a copy)