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We know you will love our service but let us prove it to you – we are offering the first $500 of fees in your first six months, on us!

That’s right – we will do all the paperwork for you and show you our premium service with a discount.

Please fill out the below form, our friendly team will then reach out to you to answer any questions you may have and get you all set up. It’s as easy as that.

Sign Up

Step 1 of 3

NAME(Required)

FIRST NAME LAST NAME

DOB(Required)

START DATE(Required)

ADDRESS(Required)

PERSONAL EMAIL(Required)

MOBILE PHONE(Required)

AHPRA NUMBER

POSTNOMINALS

PROVIDER NUMBER

PROVIDER FACILITY

DO YOU HAVE MORE THAN ONE PROVIDER NUMBER?

Yes

PROVIDER NUMBER

PROVIDER FACILITY

HAVE YOU REGISTERED WITH THE HEALTH FUNDS BEFORE?

Yes

BANK

BSB

ACCOUNT NUMBER

ACCOUNT NAME

DRIVERS LICENCE

Max. file size: 64 MB.

DID SOMEONE REFER YOU TO US?

Yes

REFEREE NAME

WOULD YOU LIKE AN @SOLOPM.AU EMAIL ADDRESS FOR YOUR PRIVATE PRACTICE? IT’S $6 PER MONTH?

Yes

PREFERRED USERNAME

ANYTHING ELSE YOU'D LIKE TO LET US KNOW?

Comments

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