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

Email

concierge@neurotms.com.au

Phone

1800 434 172

Fax

03 8677 2504

Toowong

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

Email

concierge@neurotms.com.au

Phone

1800 434 172

Fax

07 2105 5906

Bowen Hills

16 Thompson St, Bowen Hills
QLD 4006

Email

concierge@neurotms.com.au

Phone

1800 434 172

Fax

07 2105 5906

Carlton

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

Email

concierge@neurotms.com.au

Phone

03 9546 0009

Fax

03 8677 2504

Dandenong

118 David St, Dandenong
VIC 3175

Email

concierge@neurotms.com.au

Phone

03 9546 0009

Fax

03 8677 2504

East Melbourne

62 Wellington Parade, East Melbourne
VIC 3002

Email

concierge@neurotms.com.au

Phone

03 9546 0009

Fax

03 8677 2504

Mount Eliza

135 Mount Eliza Way, Mount Eliza
VIC 3930

Email

concierge@neurotms.com.au

Phone

03 9546 0009

Fax

03 8677 2504

Ballarat

11 Sturt Street, Ballarat Central
VIC 3350

Email

concierge@neurotms.com.au

Phone

03 9546 0009

Fax

03 8677 2504

Albury

470 Wodonga Place, Albury
NSW 2640

Email

concierge@neurotms.com.au

Phone

03 9546 0009

Fax

03 8677 2504