Account or Billing Enquiry

Please complete this form if you have an enquiry related to an account or billing at Bondi Doctors.

Our admin team will review your request and respond as soon as possible. Please allow up to 3 business days for us to action your enquiry.

If your enquiry is urgent, please contact reception directly by phone.

PATIENT DETAILS

Date of Submission

First Name *

Last Name *

Date of Birth *

Contact Phone Number *

Email Verification *

Send code

What does your enquiry relate to? *

Please tell us more about your enquiry (identify your credit card with the last four digits only) *

Date of invoice or consultation (if applicable)

Browse to upload a document relevant to your enquiry e.g. receipt, bank account screenshot, Medicare correspondence etc.

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Signature *

Clear

Date *