Hospital Information & Forms

If you require a general anaesthetic for your procedure, our doctors operate at 3 different hospitals:

  • Kawana Private Hospital
  • Sunshine Coast Private Hospital
  • Sunshine Coast Day Surgery
  • Gladstone Mater Hospital
  • Mater Misericordiae Hospital (Rockhampton)

Contact details for each hospital are shown below.

Medical History Form

Please download and complete your Medical History Form prior to your first consultation at MIC.  Please let our staff know if you have any queries regarding the form.

Medical History Form (PDF – 71KB)

Admission & Consent Forms

Hospital admission forms and consent forms will need to be completed by the patient as soon as possible after booking a procedure and forwarded to the appropriate hospital.

Before you print out your paperwork for the hospital, you need to obtain a CONSENT FOR OPERATION /PROCEDURE FORM from the Maxillofacial and Implant Centre. Please contact our rooms on 07 5437 9888 so we can email or fax this to you. You will need to fill this form in and send it with your paperwork to the hospital.

Hospital Admission & Consent Forms

Please download, complete and sign the appropriate forms for your procedure.  The completed form should be sent to the appropriate hospital prior to your procedure booking.

Kawana Private Hospital

14/5 Innovation Pkwy, Birtinya QLD 4575

Ph: (07) 5413 9100

Download Forms

Consent Form – Please contact us for this form
Admission Form (PDF – 3MB)

Sunshine Coast Private Hospital

12 Elsa Wilson Dr, Buderim QLD 4556

Ph: 13 13 14

Download Forms

Consent Form – Please contact us for this form
Admission Form (PDF – 5 MB)

Online Admission Link

Sunshine Coast Private Hospital Online Admission System

Sunshine Coast Day Surgery

Cnr Second & Memorial Ave, Maroochydore, QLD 4558

Ph: (07) 5443 6296

Download Forms

Consent Form – Please contact us for this form

Admission Form – Please contact us for this form

Gladstone Mater Hospital

50 Rosella St, Gladstone QLD 4680

Ph: (07) 4972 6544

Download Forms

Consent Form – Please contact us for this form

Admission Form – Please contact us for this form

Mater Misericordiae Hospital

Ward St, Rockhampton, QLD 4700

Ph: (07) 4931 3313

Download Forms

Consent Form – Please contact us for this form

Admission Form – Please contact us for this form