Referrals

If you know someone that may benefit from our service, please check with them, to if it is ok to forward their details to us in the section below.
You can be assured that we will look after them on your behalf.

Alternatively, you can:
Fax a referral on 02 9960 6166 or
Email a referral to info@medigym.com.au
Please call 02 9960 6166 if we can assist you or your referral in any way.

We have a 20 minute information DVD available, that highlights some of our clients experience.
Please visit us to collect your copy today. MediGYM: Suite 35, 600 Military Rd Mosman- Opposite Mosman Toyota, Near Crystal car Wash.



Clients Referral

Your details (member)

Your first name (required)

Your last name (required)

Your contact number

Your email address (required)

Friend’s details (guest)

Friend’s first name (required)

Friend’s last name (required)

Friend’s contact number

Friend’s email address (required)



Doctors

Patient referral

Patient’s first name (required)

Patient’s last name (required)

Patient’s date of birth

Patient’s phone number (required)

Referring GP (required)

GP’s phone number (required)

GP’s email address (required)

Condition

Reason for referral (required)