CallTheDoctor (Patient)

Request doctor form (fill out ALL details)

(1) Medicare Number

Enter your medicare number (no spaces).

(4) Medicare Patient ID Number

Medicare ID number for the patient.

(2) Family Name:

Enter your family name as shown on your medicare card.

(3) First Name:

Enter your first name as shown on your medicare card.

Phone

Please enter a phone number so we can contact you.

All fields must be completed, and a valid mobile/phone number is required.

We will validate your information and may contact you for further details before we send a doctor.

Do NOT put spaces in your Medicare or Phone number!

For URGENT medical attention, call 000