Private Practice In-Clinic Enquiry Unified Health's Private Practice In-Clinic EnquiryIf you would like to engage Unified Health’s Allied Health services within one of our private practices, please complete the details below and we will respond to your enquiry shortly.Please enable JavaScript in your browser to complete this form.CLIENT INFORMATIONPreferred In-Clinic Location: *NEWCASTLE: 86 Lawson Street, HamiltonFORSTER: 13-15 Wharf Street, ForsterBALLINA: 103 Tamar Street, BallinaAllied Health Service Required: *Occupational TherapyPhysiotherapyDieteticsExercise PhysiologyRegistered NursingFunding Source:Private ClientNDISCDM (EPC)Home Care PackageFull Name: *FirstLastDate of Birth: *Contact Phone Number: *Contact Email Address: *Home Address: *Submit
