willettonmedicalcentre.com.au
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101.0.119.10
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Submitted URL: http://willettonmedicalcentre.com/
Effective URL: https://willettonmedicalcentre.com.au/
Submission: On March 04 via api from IL — Scanned from AU
Effective URL: https://willettonmedicalcentre.com.au/
Submission: On March 04 via api from IL — Scanned from AU
Form analysis
1 forms found in the DOMPOST #
<form action="#" method="post" id="pm-appointment-form">
<div class="col-lg-4 col-md-4 col-sm-6">
<input name="pm_app_form_name" id="pm_app_form_name" type="text" class="pm-request-appointment-form-textfield" placeholder="Full Name">
</div>
<div class="col-lg-4 col-md-4 col-sm-6">
<input name="pm_app_form_email" id="pm_app_form_email" type="email" class="pm-request-appointment-form-textfield" placeholder="Email Address">
</div>
<div class="col-lg-4 col-md-4 col-sm-6">
<input name="pm_app_form_phone" id="pm_app_form_phone" type="text" class="pm-request-appointment-form-textfield" placeholder="Phone Number">
</div>
<div class="col-lg-6 col-md-6 col-sm-6">
<input name="pm_app_form_date" id="pm_app_form_date" class="pm-request-appointment-form-textfield appointment-form-datepicker hasDatepicker" type="text" placeholder="Date of Appointment">
</div>
<div class="col-lg-6 col-md-6 col-sm-12">
<input name="pm_app_form_time" id="pm_app_form_time" class="pm-request-appointment-form-textfield" type="text" placeholder="Time of Appointment (ex. 10:30am)">
</div>
<div class="col-lg-12 pm-clear-element">
<div id="pm-appointment-form-response"></div>
<input type="submit" value="Submit Request" class="pm-square-btn appointment-form" id="pm-appointment-form-btn">
<p class="pm-appointment-form-notice">All fields are required.</p>
<a href="#" class="pm-appointment-form-close" id="pm-close-appointment-form"><i class="fa fa-close"></i> Close Appointment form</a>
</div>
<input type="hidden" value="admin@willettonmedical.com.au" name="pm_app_form_recipient" id="pm_app_form_recipient">
<input type="hidden" id="pm_ln_send_appointment_nonce" name="pm_ln_send_appointment_nonce" value="742f607d09"><input type="hidden" name="_wp_http_referer" value="/">
</form>
Text Content
All fields are required. Close Appointment form (08) 9310 1234 * Home * About * Our Doctors * Nursing Team * Reception Team * Allied Health Practitioners & Services * Clinics * Iron Infusion Clinic * Covid-19 Clinic * Chronic Disease & Health Assessment Clinic * Kids Clinic * Men’s Clinic * Women’s Clinic * Billing * FAQ * Contact * Forms * What’s New * * MEN’S CLINIC Take a more proactive approach to your health.... [...] Read More WOMEN’S CLINIC Providing comprehensive medical care in the area of women’s health. [...] Read More CHRONIC DISEASES & HEALTH ASSESSMENT CLINIC A chronic medical condition is a condition that has been (or is likely to be) present for six months or longer [...] Read More IRON INFUSION CLINIC Have you been feeling tired and run down? It may be related to a lack of essential iron in your blood. [...] Read More KIDS CLINIC We'll take great care of your kids! Including vaccinations, treatment of injuries and childhood illnesses. [...] Read More ABOUT WMC Willetton Medical Centre is a state-of-the-art medical facility committed to excellence in health care. OPEN 7 DAYS Monday to Friday – 8.00am to 5.30pm Saturday/ Sunday- 9.00am to 3.00pm AFTER HOURS CARE Night Doctor Tel: 1300 644 483 Monday – Friday 6.00pm to 8.00 am Saturday 12 Noon – Monday 8.00am 24 Hours on Public Holidays Dial-A-Doctor (Bulk Billed Home Visits) Ph: 1300 030 030 Weeknights: 6.00 pm – 8.00 am the following day Weekends: Sat 12 noon – 8.00 am Monday morning All Public Holidays BILLING We are Private Billing practice. Please view our billing information available from the main menu. “Please note that new patients to Willetton Medical Centre will not be prescribed any schedule 8 medication or drugs of addiction prior to Willetton Medical centre receiving a complete medical history from your prior GP and any appropriate medical assessment required, at the discretion of our doctors.” BOOK APPOINTMENT Powered By