Request appointments

Employer or company booking.

Give us the company details and the seafarers you need seen. A member of the clinic team will contact you to agree times. Nothing on this page books an appointment.

What you can and cannot do here

Each seafarer completes their own forms

You can give administrative and scheduling details for your seafarers. You cannot complete a seafarer’s medical questionnaire or sign their consent on their behalf, and this form does not ask you to.

Once appointments are agreed, each seafarer receives their own link to the consent and release form and the AMSA medical questionnaire.

Details are handled under our privacy policy.

Your company

Company name

ABN(optional)

Contact person

Role or position

Email address

Contact number

Billing address

Where the invoice should go.

Purchase order number(optional)

Mobilisation deadline(optional)

If your seafarers must be certified by a date, tell us.

Seafarers (1)

Administrative details only. Each seafarer completes their own consent and medical questionnaire after the clinic makes contact.

Seafarer details. Scroll sideways to reach every column, or switch to the cards view.
Full legal name	Date of birth	Mobile	Email	Street address	Suburb	Postcode	First time at sea	Preferred clinic	Preferred date	Preferred time	Remove
Full legal name, seafarer 1	Date of birth, seafarer 1	Mobile, seafarer 1	Email, seafarer 1	Street address, seafarer 1	Suburb, seafarer 1	Postcode, seafarer 1	First time at sea, seafarer 1	Preferred clinic, seafarer 1	Preferred date, seafarer 1	Preferred window, seafarer 1