Request A Health Examination  

To request a health examination, please complete the form below and press the 'Submit' button. A member of our staff will contact you to confirm details of the appointment.

Click here for a Pre-employment Medical

Click here for a Workplace Referral

 

* Required Fields

Health Appointment Required *

 
Patient Details  
Name of Patient:*
Address  
Street:
Town/Suburb:
Postcode:
Daytime contact telephone number:*
   
Your Details
(if different from above)		  
Name:
Company:
Contact telephone number:
Contact e-mail address:
 






ERA Health
563 Bourke Street, Melbourne VIC 3000  |  Phone: 9944 6200  |  Email: info@erahealth.com.au
Melbourne Cargo Centre, Melbourne Airport  VIC  3045   |  Phone:  8335 0600  |  Email:  reception@erahealth.com.au