Please enter your information
Please use your university issued email address, e.g. email@example.com
If you would like to provide documentation relating to your condition prior to your appointment, please upload as indicated below. If you do not have relevant documentation about your condition or caring responsibilities, please ask a Health Professional to complete this form and bring with you when you see us.
All information you provide is confidential. Further details can be found here: http://www.student.uwa.edu.au/experience/health/uniaccess.