UniSA Health Clinics – Appointment Booking Form - Connect with UniSA

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class="unicon-person theme-icon-blue-2 icon20" style="float: left; margin-right: 10px;"></span><a href="http://search.unisa.edu.au/s/search.html?collection=study-search&f.Tabs%7Ctab=People"> Staff directory</a></li> </ul> </li> </ul> </div> <div class="columns"> <ul> <li class="pillar-subheading"><a href="/about-unisa/academic-units/" rel="noopener" tabindex="-1">Academic Units</a></li> <li class="pillar-subheading"><a href="/about-unisa/working-at-unisa/" tabindex="-1">Working at UniSA</a></li> <li class="pillar-subheading"><a href="/about-unisa/publications/" tabindex="-1">Publications</a></li> <li class="pillar-subheading"><a href="/about-unisa/aboriginal-engagement/" tabindex="-1">Aboriginal engagement</a></li> </ul> </div> <div class="columns"> <p class="discover-header-image"><a href="https://adelaideuni.edu.au/" target="_blank" rel="noopener"><img class="image-rounded" src="/contentassets/fb38a1ec91da47908227292e8e6ad649/adelaide-university-website-shoot1.jpg" alt="Discover Adelaide University" width="500" height="220" /></a></p> <ul> <li class="pillar-subheading"><a href="https://adelaideuni.edu.au/" target="_blank" rel="noopener">Discover Adelaide University</a></li> </ul> <p class="discover-header-text" style="margin-top: -20px;">Learn more about South Australia's new university for the future</p> <style> @media (max-width: 64em) { p.discover-header-image { display: none; } p.discover-header-text { display: none; } } </style> </div> </div> </div> </li> </ul> </li> </ul> </div> </div> <div class="secondary-navigation-wrapper theme-background-blue-10"> <div class="secondary-navigation row"> <ul class="toolbar"> <li class="utility-login page-login-panel-toggle"> <button> <span class="theme-white">Login</span> <span class="utility-login-icon theme-blue-2 icon15"></span> </button> <div id="LoginPanel" class="LoginPanel page-switch-login-panel theme-white display-none"> <ul class="theme-background-white" style="background-color:white"> <a href="https://my.unisa.edu.au/public/staffweb/"> <span class="svg-wrapper icon15" ><svg class="team"><use xlink:href="/Static/assets/icons/icons.svg#team"></use></svg></span> Staff </a> <a href="http://i.unisa.edu.au/students/"> <span class="svg-wrapper icon15" ><svg class="future-student"><use xlink:href="/Static/assets/icons/icons.svg#future-student"></use></svg></span> Students </a> <a href="/connect/alumni-network/"> <span class="svg-wrapper icon15" ><svg class="graduate-cap"><use xlink:href="/Static/assets/icons/icons.svg#graduate-cap"></use></svg></span> Alumni </a> </ul> </div> </li> <li class="utility-search search-panel-toggle-button" type="button"> <span class="unicon-search-nav theme-white"> </span> </li> <li class="utility-menu" style="position:relative"> <button class="hamburger hamburger--spin" aria-label="Menu" type="button" aria-expanded="false"> <span class="hamburger-box"> <span class="hamburger-inner"></span> </span> </button> </li> </ul> <div class="main-nav-sub-item mega-menu-panel home-slider-wrapper search-header-panel"> <form class="search-form " method="post" action="https://search.unisa.edu.au/s/search.html?collection=study-search&f.Tabs|tab=Everything"> <div class="row"> <div class="columns"> <div class="input-group" style="position: relative;"> <label for="383050fb-search-block-searchterm"></label> <input name="query" id="383050fb-search-block-searchterm" class="input-fb-search-block input-group-field query" autocomplete="off" type="text" placeholder="How can we help you?" value="" oncancel="this.onchange();" onmouseup="this.onchange();" onreset="this.onchange();" onkeyup="this.onchange();" onpaste="this.onchange();" oninput="this.onchange();" onclick="this.onchange();" onchange="fbSearchBlockButton(383050);" /> <div class="input-group-button"> <button id="383050fbSearchButton" type="submit" value="Submit" class="button icon-only search-button theme-blue-5 theme-icon-blue-5" disabled="disabled"> <span 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0-27.9-7.7-7.7-20.2-7.7-27.9 0L250 222.6 58.3 31c-7.7-7.7-20.2-7.7-27.9 0-7.7 7.7-7.7 20.2 0 27.9l191.7 191.7L30.5 442.2c-7.7 7.7-7.7 20.2 0 27.9 7.7 7.7 20.2 7.7 27.9 0L250 278.4 441.7 470c7.7 7.7 20.2 7.7 27.9 0 7.7-7.7 7.7-20.2 0-27.9L277.9 250.5z"></path> <path fill="none" d="M-4410.5-10253.9h6006.7V2655.5h-6006.7z"></path> <path fill="none" d="M-4410.5-10253.9h6006.7V2655.5h-6006.7z"></path> <path fill="none" d="M-4410.5-10253.9h6006.7V2655.5h-6006.7z"></path> <path fill="none" d="M-4410.5-10253.9h6006.7V2655.5h-6006.7z"></path> <path fill="none" d="M-4410.5-10253.9h6006.7V2655.5h-6006.7z"></path> <path fill="none" d="M-4410.5-10253.9h6006.7V2655.5h-6006.7z"></path> </svg> </span> </button> </div> </form> </div> </div> </div> </div> </header> <div class="header-overlay-wrapper"> <div class="pillar-overlay-background"></div> </div>   <div class="layout-block slideshow-breadcrumbs no-padding"> <div class="row"> <div class="breadcrumbs-outer theme-grey-text theme-links-blue-6 theme-links-hover-blue-7 margin-bottom"> <div class="breadcrumbs-inner row small-collapse medium-uncollapse"> <div class="columns"> <ul class="breadcrumbs"> <li> <a href="/">Home</a> </li> <li><a href="/connect/">Connect</a></li> <li><a href="/connect/community-clinics/">Community Clinics</a></li> </ul> </div> <a href="#" class="breadcrumbs-trigger">+</a> </div> </div> </div> </div>   <div class="unisa-full-width-content"> <div class="layout-block"> <div class="row"> <div class="columns medium-9 medium-push-3 unisa-main-content"> <style></style> <h1>UniSA Health Clinics – Appointment Booking Form</h1> <p><strong>Please note that students are unable to see clients in relation to Medicare, Private Health and WorkCover Insurance claims.</strong></p> <p>If you are unable to complete this form please call the UniSA Health Clinics on 8302 0986.  Messages can be left on the voicemail service if a receptionist is unavailable.</p> <script type="text/javascript"> 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data-f-datainput> <option disabled="disabled" selected="selected" value="">-- Select an option --</option> <option value="Physiotherapy" data-f-datainput>Physiotherapy</option> <option value="Physiotherapy for Children" data-f-datainput>Physiotherapy for Children</option> <option value="Podiatry" data-f-datainput>Podiatry</option> <option value="Exercise Physiology" data-f-datainput>Exercise Physiology</option> <option value="Occupational Therapy" data-f-datainput>Occupational Therapy</option> <option value="Midwifery" data-f-datainput>Midwifery</option> <option value="Speech Pathology" data-f-datainput>Speech Pathology</option> <option value="Mental Health and Wellbeing" data-f-datainput>Mental Health and Wellbeing Services (Social Work, Psychology, Mental Health Nursing)</option> </select> <span class="Form__Element__ValidationError" data-f-linked-name="__field_621315" data-f-validationerror="" id="__field_621315_desc" style="display:none"></span> </div><div class="Form__Element FormSelection ValidationRequired" data-f-element-name="__field_621314" data-f-type="selection"> <label for="f4429ac4-2a30-492f-913f-6dd0b92e5796" class="Form__Element__Caption">Which clinic location do you prefer?</label> <select name="__field_621314" id="f4429ac4-2a30-492f-913f-6dd0b92e5796" required aria-required="true" data-f-datainput> <option disabled="disabled" selected="selected" value="">-- Select an option --</option> <option value="City East Podiatry" data-f-datainput>City East Podiatry</option> <option value="City East Physiotherapy" data-f-datainput>City East Physiotherapy</option> <option value="City East Exercise Physiology" data-f-datainput>City East Exercise Physiology</option> <option value="City West Health and Medical Clinic" data-f-datainput>City West Health and Medical Clinic (all services)</option> <option value="Magill Allied Health Clinics" data-f-datainput>Magill Allied Health Clinics (Physiotherapy, Exercise Physiology and Podiatry only)</option> <option value="UniSA Health Clinic Elizabeth" data-f-datainput>UniSA Health Clinic Elizabeth</option> </select> <span class="Form__Element__ValidationError" data-f-linked-name="__field_621314" data-f-validationerror="" id="__field_621314_desc" style="display:none"></span> </div><div class="Form__Element FormParagraphText Form__Element--NonData" data-f-element-name="__field_621316" data-f-element-nondata=""> <div id="dff6ad3f-d00c-4cb4-acc2-90feb45ce754" ><p class="intro">Your privacy is important to us. 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