Rapid Access Skin Cancer Service

Request an Appointment

Complete the form and we will contact you to provide you further information and schedule an appointment.

Please note, if you have a referral from your GP, please submit this to us using the following link instead: https://dermatology.melbourne/referral/

First Name *

Last Name *

DOB *

Email Address *

Phone Number *

Full Address *

Post Code *

Reason for Visit *

I consent to being contacted by phone, SMS or email. *

Email to patient *

Appropriate for Rapid Access Skin Cancer ServiceNeeds to see a dermatologistCustom Response

Custom response *