ONLINE CONTACT FORM

Interested in seeing one of our specialists? Please complete the form below to request an appointment with one of our specialists. A current referral is required to be seen in our practice. Once submitted, our team will review your information and contact you to assist with the next steps!

* Indicates required field

Full Name *

Date of Birth *

Contact Number *

Email *

Address *

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City

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Are you a new or existing patient at QRS? *

New referral Exisiting referral Existing patient at alternative clinic

How can we help? *

Referral (if applicable) *

Max file size: 20MB

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OUR WIDE RANGE OF SERVICES:
REHABILITATION MEDICINE
PAIN MEDICINE
PAEDIATRIC REHABILITATION MEDICINE
NEUROLOGY
PHYSIOTHERAPY
PSYCHOLOGY
OCCUPATIONAL THERAPY
MEDICOLEGAL ASSESSMENTS
INJECTABLES

LOCATION:
75 BROUGHAM ST,
FAIRFIELD QLD 4103

CONTACT US:
PHONE: 07 3393 2001
FAX: 07 3393 2002
EMAIL: [email protected]

OPENING HOURS:
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY

8.00am - 5.00pm
8.00am - 5.00pm
8.00am - 5.00pm
8.00am - 5.00pm
8.00am - 3.00pm
CLOSED
CLOSED