Complete the form below.
Write NO MORE THAN ONE WORD OR A NUMBER for each answer.
Oakham Surgery New Patient Form
Example NEW PATIENT’S ROAD |
Answer Dawson Road |
FULL NAME | Mike 1 |
WIFE’S FIRST NAME | Janet |
CHILDRENS’ FIRST NAMES | 1st 2 2nd 3rd 4th |
ADDRESS | 52 Dawson Road 3 Melbourne |
HEALTH CARD NUMBER | 4 |
WIFE’S HEALTH CARD NUMBER | will give later |
PREFERRED DOCTOR SELECTED | 5 White |
Circle the correct letters A, B, or C.
源 1
源 2
Mike (man) Hello. I’ve just moved to Melbourne for a new job and I’ve been advised to register with a new doctor for my family and myself. I think that this surgery is the nearest one to where I live.
Recept: What’s the name of the road that you live in sir?
M: Dawson Road.
R: Yes. That’s in our area. Would you like to register with us now?
M: Yes please.
R: Right. I’ll just have to take some details. First of all, could you give me your name?
M: It’s Mike Jacobs. J-A-C-O-B-S.
R: And your family?
M: My wife’s name is Janet and I have one little boy whose name is Rod.
R: Ron?
M: No, Rod. R-O-D.
R: Good, that’s fine. And what is your address here in Melbourne?
M: 52 Dawson road, Highfield. Melbourne.
R: Highfield. H-I-G-H-F-I-E-L-D . Good. And I’ll need to know your health cardnumber.
M: It’s NH eight seven one eight one C. What about my family?
R: Oh, only yours for now. Do you know the name of your old doctor?
M: It was Dr. Graham McKenzie in Perth.
R: Now, we’ve got 4 doctors here. There’s Dr. Susan Larkins, Dr. Kevin White, Dr. James Nicholson and Dr. Linda Williams. Which one would you like to register with?
M: Oh! I didn’t think of that. Well, I think I would like a man as my doctor. I’ll go for the last one. Was that one a man?
R: No, that was Dr. Linda. How about Dr. Kevin?
M: Yes, that will be fine.
R: Right. Dr. White it is. Will that be the same for your family?
M: Oh yes. My wife might not want a man as her doctor. Well, we’ll leave it as it is for now and my wife can change if she wants to.
M: I’d like to make an appointment now for my wife. She wants to come in at the end of the week.
R: How about this Friday morning? That’s Friday the 21st .
M: Mmm, I don’t think she can make the morning. Any openings in the afternoon?
R: There are appointments available at 2.00, 2.30 and 3.30.
M: We’ll take the first one please .
R: Ok. That’s done.
M: Oh. And what shall my wife do if she wants to switch doctor?
R: She can just give us a call here. Do you want to take the number down?
M: Yes please.
R: It’s seven two five three nine eight two nine.
M: Can you give me your name please?
R: My name’s Angela but there are two other girls who might be on duty as well. Their names are Elizabeth and Rachel but it doesn’t matter who’s on duty. Anyone can take care of it.
M: Now what do we do if we need to call out a doctor during the night?
R: We’ve got a rotation system with the doctors in the area. There’s a mobile and you can call and that’ll get through to the doctor who’s on duty.
M: What’s that number?
R: It’s zero five zero six seven five nine three eight five six. Got that. I didn’t ask about any charges.
R: Like all Australia, prescriptions have to be paid for at the chemist at the prevailing rate. Some things like vaccinations for travel and insurance reports we make a standard charge for and I can give you a price list for those. consultations though are under the National Health Service so they’ll be free.
M: Great. Well that’s all. Thanks and goodbye.
R: Goodbye.
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