Patient Forms
We ask that all patients complete a Registration Form prior to their arrival. Some patients with gut related concerns and seeing a colorectal surgeon, gastroenterologist, pelvic floor physiotherapist or dietitian will also be asked to complete a Bowel Symptom Questionnaire. Your appointment letter will provide details regarding which form/s you need to complete. Please check this carefully. Your personal information is kept secure in our proprietary patient information system
Intus Registration Form
This form is the first step in registering as a patient with us. It captures your general and medical information. Please complete every question and submit to Intus before your appointment. The form will take approximately 10 minutes to complete. We may also ask you to complete this form if we haven’t seen you for a while.
Important
Please take time to gather all the required information before filling this form out online. This includes your insurance information, contact information for your referring GP & your current medications.
Your information will get sent directly through to our medical records and will not be stored anywhere else.
Items marked * indicate mandatory fields.
On successful completion you will see a successful submission message. If you do not see this, your form has not been submitted.
If you are experiencing issues completing your Registration Form online, please contact (03) 977 5977 and one of our support staff will be happy to assist you.
Bowel Symptom Questionnaire
This questionnaire has been developed to establish a clearer analysis of your individual concerns. Completion is voluntary and is kept as part of your clinical record. This questionnaire may be repeated to reassess your progress. You only complete this questionnaire if you are a registered patient at Intus and have been requested to do so to complete your registration.
Important
Your information will get sent directly through to our medical records and will not be stored anywhere else.
Items marked * indicate mandatory fields.
If you are experiencing issues completing your bowel symptom questionnaire, please contact (03) 977 5977 and one of our support staff will be happy to assist you.