Epping Surgery Centre 34 Boronia Ave, Epping NSW 2121

(02) 9868 6555

Online Pre-Admission Form


In order to ensure your admission is streamlined, we request that you complete this hospital pre-admission form at least 2 weeks prior to your admission date.

  • Please ensure you are able to complete this form uninterrupted
  • You will need approximately 20 minutes to fill in this form
  • Fields that are mandatory are marked with an asterisk (*).
  • This form cannot be completed without an admission date and procedure name. Please contact your SurgeonĀ if you do not have these details.

Important! To assist you with this process, please have the following information at hand.

  • Your personal details and support person details
  • Emergency contact details (Next of Kin /Carer)
  • Medicare card
  • Health Fund details
  • Specialist details, including admission date and procedure name
  • List of medication(s) and dosage

When you have completed filling in your admission form, you will be prompted to ensure that your details are correct before continuing.