Patient Registration

Please put the day of expiry as the last day of the month

I understand that the account holder listed will receive the Medicare rebate for any appointments and surgeries

Dr. Jefferson is unable to book patients on to public operating lists from his private rooms. If you are not privately insured and not in a position to pay for surgery out of pocket please let our receptionists know. They will forward your referral to the public outpatient clinic at John Hunter Hospital for you to be seen through the public system.

I understand that the practice keeps my information safe and secure in accordance with the national guidelines. To read our privacy policy click here. I understand that my information may be disclosed to other individuals involved in my health care outside of this practice

I understand that payment is required on the day of service via cash, EFTPOS or cheque, and that failing to attend will incur a fee.

* Initial Consultation: $240.00 (medicare rebate $76.15)
* Initial Pensioner Consultation: $190.00 (medicare rebate $76.15)
* Follow up Consultation: $125.00 (medicare rebate $38.25)
* Follow up Pensioner Consultation: $100.00 (medicare rebate $38.25)

I agree to pay any and all fees associated with my consultation

I agree to be bulk billed for any procedures performed by Dr Niall Jefferson in his private rooms, with a valid Medicare card and referral

Dr Jefferson may take photos inside of your ears, nose or throat. These photos are stored securely within your medical record. These photos do not contain any identifying features. Dr Jefferson may use these images for teaching purposes without your name attached.

Ear Nose Throat Newcastle love ensuring that our social media and website are kept up-to-date. If our staff see a photo opportunity whilst you are in the practice, would you be happy for your photo to be used on our social media pages and website?