Forms for existing / current patients
If you have been seeing Dr. Binjemain in IMH Gold Coast or NIIM Gold Coast, please click the link below to request your notes to be transferred to WIllowVale Clinic
If you are wanting to have a follow up appointment with Dr. Binjemain, please click the link below to fill out the follow-up form. If the form is not sent 48hrs before your appointment, we may have to give away the appointment to another patient, as we need time to gather together necessary test results for your appointment.
If you are having or planning to have intravenous therapy, please read and sign this CONSENT FORM