Patient Questionnaires

To assist the specialist assess your symptoms and create a personalised management plan, please download and complete these questionaries prior to your appointment.

If you have previously filled in these forms and have started any treatment, please complete the relevant forms again to help the specialist objectively compare your response.

If you have any Voiding or Urinary Symptoms:

printUrinary Symptoms Questionnaire

If you have any Erectile Dysfunction:

printErectile Dysfunction Questionnaire

If you have any concerns about Low Testosterone:

printLow Testosterone Questionnaire

If you have any concerns about Male Fertility:

printMale Fertility Questionnaire

Once these forms have been completed, please

1) Scan and email to: [javascript protected email address]
2) Fax: + 61 3 8658 9521

Although it is preferable to email or fax the forms, if you are unable to do so, please bring them to your next appointment.

For new patients, or if any of your details have changed, please rememeber to complete the below form and submit.

New Patient Information & Consent Form

To download, printclick here

printPatient Questionnaire