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Pharmacy: Galston Healthsense Pharmacy

Address: Shop 1
354 Galston Road
GALSTON, NSW, 2159

Phone: 02 9653 1104

Guild Corp Health Vaccination details

Appointment duration: 30 min

Choose A Date:

BOOSTRIX

Duration: 30 min

BOOSTRIX

EAR PIERCING

Duration: 30 min

EAR PIERCING

FLU VAX

Duration: 15 min

FLU VAX

FLU VAX OVER 65

Duration: 15 min

FLU VAX OVER 65

Guild Corp Health Vaccination

You can request for a Guild Corporate Health at our pharmacy. Book for a consultation with one of our pharmacists.

Duration: 30 min

Guild Corp Health Vaccination

IMMUNISATION

Duration: 15 min

IMMUNISATION

MODERNA VAX

Duration: 15 min

MODERNA VAX

PFIZER VAX

Duration: 30 min

PFIZER VAX

Pre-Screening Form

Booking Details

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Your Details

First Name:

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You have been sent an email with these details. You will also receive a reminder 24 hours before your booking.

Save time on your visit by answering questions before your appointment.

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Enter Your Details:

First Name*

Last Name*

Mobile*

Email*

Gender*

Dose

Medicare Number

IRN

Medicare Expiry

Name on card

Enter your Medicare number and other details to reduce your waiting time in the pharmacy.

Date of birth*

Street*

Suburb*

State*

Postcode*

Reason for consultation*

What are you experiencing with your health? Provide information to help with the consultation.

Relevant background information*

Include information relevant to your situation e.g. medication you are on, recent health issues, allergies etc.

I am consenting as a substitute decision-maker (e.g. carer) on behalf of the patient

Name of substitute decision-maker*

Consent to pilot clinical service and costs*

I agree to participate in the pilot and understand the scope of the clinical service. I consent to paying the pilot consultation fee and any costs associated with the service. I understand that if I decide not to proceed with receiving some part of a service, I may still be required to pay for services that have already been provided.

Consent to pilot evaluation*

I consent to participating in the evaluation of the pilot and agree to being contacted to participate in surveys about the pilot. I consent to my administrative health service data being analysed for evaluation purposes.

Organisation Code*

Division*

Employee Status*

Participant ID*

Service selection*

I have read and accept the Guild Corporate Health Privacy Policy. I give consent for the pharmacy to provide my personal information to my employer for reconciliation and program management purposes. *

I have read and accept the MedAdvisor Terms and Conditions and Privacy Policy. *

This program closes at 4pm AEST July 31st. Do not book a vaccination after this date/time.

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