Recall Please fill in the information below and we will be in contact with an appointment or procedure date.

 
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Clinical Questionnaire

If you answer no to Q5, please skip to Q8.
Please advise if you are taking any other blood thinning medication other than the blood thinners mentioned above.
A valid referral must be submitted to proceed with your procedure with our specialists. Please contact our office on 02 9398 0200 if you have any questions. If you are having problems uploading your referral, please email it to admin@segsydney.com.au.