TMS Referrals | NeuroTMS

Refer Your Patient

Please use this form to refer your patient to NeuroTMS. Our Concierge will contact your patient the same business day to arrange the best available consultation appointment.

Note: fields marked with * (asterisk) must be filled.

Thank you.

Patient Information

First Name*

Last Name*

Email*

Phone*

Patient’s Insurance (if known)

Private Health Insurance

Worker Compensation

TAC

DVA

Relevant History

Referring Doctor

Full Name*

Provider Number*

Your Email*

Your Phone*

NeuroTMS Clinic Locations

NeuroTMS Head Office

Suite 3, Level 1, 19-21 Argyle Place South, Carlton
VIC 3053

Email

treatmentservices@neurocentrix.com.au

Phone

1800 434 172

Fax

03 8677 2504

Toowong

Suite 2, Level 5, 49 Sherwood Rd, Toowong
QLD 4066

Email

treatmentservices@neurocentrix.com.au

Phone

1800 434 172

Fax

03 9959 8375

Carlton

Suite 3, Level 1, 19/21 Argyle Pl S, Carlton
VIC 3053

Email

treatmentservices@neurocentrix.com.au

Phone

03 9546 0009

Fax

03 8677 2504

Dandenong

118 David St, Dandenong
VIC 3175

Email

treatmentservices@neurocentrix.com.au

Phone

03 9546 0009

Fax

03 8677 2504

Mount Eliza

135 Mount Eliza Way, Mount Eliza
VIC 3930

Email

treatmentservices@neurocentrix.com.au

Phone

03 9546 0009

Fax

03 8677 2504

Ballarat

11 Sturt Street, Ballarat Central
VIC 3350

Email

treatmentservices@neurocentrix.com.au

Phone

03 9546 0009

Fax

03 8677 2504

Launceston

Level 4 QV Tower, 11 High Street, East Launceston
TAS, 7250

Email

treatmentservices@neurocentrix.com.au

Phone

03 6145 0626

Fax

03 9959 8375