For added convenience and to save time, you can download all the required patient and surgical forms here.
BOOKING AN APPOINTMENT
Bookings are now done electronically by clicking the Appointment Request button below. You can select the surgeon you wish to see on the online form that appears. For appointments with Prof Lubbe, kindly read the requirements below.
Dr Goncalves
Complete and submit the online form by clicking the button below. On receipt of your request, we will contact you to arrange your appointment.
Prof Lubbe
To request an appointment with Prof Lubbe, you will need to provide:
- A referral letter from a specialist.
- All scans of the problematic region (CT or MRI) if already performed.
- Histology results (if available)
You will be prompted to upload these items before you submit the form. On receipt of your request, we will contact you to arrange your appointment.
BEFORE YOUR FIRST APPOINTMENT
Please complete and submit the New Patient Form before your appointment.
BEFORE YOUR SURGERY
Kindly download and complete all the forms below, prior to your surgery.
- Pre-surgery Info: This form should be downloaded and read as soon as possible. It contains important pre-surgery information, including medical aid authorisation requirements, medication information, account information, and more.
- Surgical Consent: This form details the kind of surgery that will be performed, and the associated risks.
- Evidence of Consent: This is the hospital form detailing the kind of surgery being performed, which must be signed by both patient and doctor.
- Mediclinic Admission: Completing this form prior to admission will help streamline the admission process.
PRE-SURGERY INFO
Dr Goncalves – Download PDF
Prof Lubbe – Download PDF
SURGICAL CONSENT
Dr Goncalves – Download PDF
Prof Lubbe – Download PDF
EVIDENCE OF CONSENT
