Caring for the Health of the Community for Over 60 Years

Ph: (08) 8294 5555
Glenelg, South Australia

Patient Admission Forms

To submit your Patient Admission Forms electronically please follow the steps below. Please note that you must open the Patient Admission Forms & Advice from where you have saved them on your computer once you have downloaded them to complete not through your web browser.

Step 1: Download the Patient Admission Forms & Advice booklet.

Step 2: Save As to your Computer (ensure you save as prior to completing the booklet)

Step 3: Open the Patient Admission Forms and Advice from where you have saved it on your computer and complete pages 5-8 and Save.

Please note when completing the forms:

  • Page 6, please do not sign Patient Account Responsibility, Consent to Collect and IUse information adn Rights and responsibilities you will be asked to do so on admission.
  • Pages 10-11 Consent Form will be completed with your Doctor, prior or the day of admission.

Step 4: Attach the saved completed Forms to a new email and send to reception@gchi.com.au

To avoid admission delays, forms should be at the hospital at least 14 business days prior to admission.

If unable to do so, contact Pre-admissions with your details as soon as possible & then bring completed forms with you on admission.

Where payment is required prior to admission Glenleg Community Hospital accepts cash, bank cheques, money orders, EFT, eftpos, Visa and MasterCard for any amounts payable.  Amex, Diners, personal or business cheques will not be accepted. Please contact Reception on 08 8294 5555 if you have any queries regarding payments.

Further information for Department of Veterans' Affairs arrangemnet can be accessed here.

If you wish to complete a Patient Satisfaction Survey please follow the below steps:

  • Download the Patient Satisfaction Survey here
  • Save As to your Computer
  • Complete the form and Save
  • Return the saved completed form via email to reception@gchi.com.au
Glenelg Community Hospital is committed to providing quality, holistic healthcare services to its community.