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Initial Appointment

An Initial consultation with Dr George Balalis or Dr Jesse Beumer is $280.00. A valid referral is required for this appointment and you will receive a Medicare rebate of approximately $80.85.

Details for your referring doctor

Dr George Balalis or Dr Jesse Beumer Phone: 08 8164 6945 Fax: 08 8490 3283 Email: [email protected], 149 Ward Street, North Adelaide, 5006

Other important details

It is important to attend your appointment with an up to date list of any medications you are currently taking. Other important information for your surgeon includes; endoscopy/colonoscopy reports within the last 2 years. Any other related investigations of your abdomen, including CT scans and ultrasounds preformed in the last 12 months.

Patient Details

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Address
Our practice sends appointment and recall reminders via email and mobile text messages, do you consent to this?
To assist with health initiatives, are you Aboriginal or Torres Strait Islander?

Medical account details




Do you have Private Health?
Do you have hospital cover?
Do you have top Hospital Gold Cover? (If seeing us to discuss weight loss surgery, you may like to check with your health fund if you are covered for the following item numbers; 31575, 31572, 31585, 31584).

Doctor Details

Do you have a referral?
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Emergency Contact Details:

Emergency Contact Consent
Consent for emergency contact medical information
Consent for appointment information to my emergency contact
Do you have any previous illness, medical conditions or surgery we need to be aware of?
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