Update your Contact Details

Thank you for taking the time to update your details.  All of these details are considered a part of your clinic records and as such are subject to the same privacy and confidentiality restrictions inherent in the client-practitioner relationship.

This helps us continue to give you the best service we can, and keep you up to date with the many happenings and changes which are going on right now.  Please just enter your name and any details which are likely to need updating.

Please also take the time to join us on Facebook.  If you are on a waitlist, please also join our Twitter Offers List to receive tweets of vacant and no-longer vacant appointment offers.  Please note that all appointment functions must be conducted by phone for privacy reasons.

Your name in full as on our records (Required)
 

Residential Address:

Address 1
Address 2
Suburb/City  
State   Post Code

Postal Address:

Address 1
Address 2
Suburb/City  
State   Post Code

Contact details and methods - please use the box after each method to rank your contact details so we can reach you for appointment offers etc. as quickly as possible with "1" as your most preferred contact method to "5" as your least preferred.

Home Phone 
rank 0 1 2 3 4 5  
Work Phone (incl. ext) 
rank 0 1 2 3 4 5
Mobile Phone
rank 0 1 2 3 4 5
Email address? 
rank 0 1 2 3 4 5
Alternate contact details (Care of..) 
rank 0 1 2 3 4 5
 

We publish a newsletter a few times per year (as news becomes relevant).  Please check this box if you DO NOT want us to send you our email newsletter.

Please do not send me email newsletters.

(View our booking conditions)