Request to Access SystmOnline (Adelaide St)

Through our online services you can book appointments, manage your repeat medication and view some areas of your medical record.

Last Updated: 21/05/2020

Register for Online Services







Signature

Please note that if you are requesting a password and login for a young person under the age of 12 years (this will make you a “Proxy” user). Once this young person reaches 12 years, for the purpose of patient confidentiality your access to their SystmOnline account will automatically be disabled. If you are registering for your own online services you will need to complete this form and return it with photographic ID. If you are registering for a “proxy” user you will need to supply photographic ID and proof that you have parental responsibility for the young person (i.e their birth certificate).




For surgery use only

NOT TO BE COMPLETED BY THE PATIENT