Account or Billing Enquiry

Please complete this form if you have an enquiry related to an account or billing at Double Bay Doctors.

Please allow up to 2 business days for your account/billing enquiry request to be actioned.

PATIENT DETAILS

First Name *

Last Name *

Date of Birth *

Contact Phone Number *

Email Verification *

Send code

What does your enquiry relate to? *

Please tell us more about your enquiry (identify your credit card with the last four digits only) *

Date of invoice or consultation (if applicable)

Browse to upload a document relevant to your enquiry e.g. receipt, bank account screenshot, Medicare correspondence etc.

Browse

Signature *

Clear

Date *