Pre-Screening Form | Telehealth Consultations

Please note: This questionnaire is not medical advice and it does not diagnose any condition. It only helps us see whether our service may suit you. Any decision about treatment is made by a qualified practitioner during a consultation. Prescribed medicines are regulated by the Therapeutic Goods Administration. Treatment may not work for you, and side effects are possible.

Do you have a medical condition that has been causing you distress for 3+ months?

This helps us understand your situation.

Yes

No

Have you tried treating your condition with prescription medication or any other care methods?

We ask this to understand your healthcare history.

Yes

No

Were you unsuccessful in treating your condition?

Select the answer that applies to your situation.

Yes

No

Your Details

First Name

Last Name

Email

Phone/Mobile

The information you are providing to us may include personal information as defined under the Privacy Act 1988 (Cth).

I consent to providing health information so GreenMend can assess whether a consultation suits me. See our Privacy Policy. I can withdraw my consent at any time.

I agree to the terms and conditions

Yes, keep me informed about GreenMend services, and email me if our criteria change.

Thank you for taking the time.

Based on your answers, we are not able to offer you a consultation right now.
Our service currently suits people who have been managing an ongoing health concern for three months or more, and who have already tried other options.

We review our criteria from time to time. We do not have your contact details, so we cannot let you know when that happens.

If you would like to hear from us, or you think this result does not reflect your situation, please write to us at [email protected]. A qualified practitioner can talk through your circumstances with you.

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This form does not create a doctor and patient relationship. A consultation may result in advice, referral, monitoring, lifestyle guidance, further investigation, or no treatment. Any treatment is provided only if deemed medically appropriate.

Telehealth is not suitable for all health concerns. Your practitioner may recommend in-person assessment, urgent care, GP review, a referral to another doctor, further investigation or no treatment depending on your circumstances.

Individual results vary. Assessment findings do not guarantee a particular outcome.

We do not advertise specific prescription medicines to the public in accordance with Australian regulatory requirements.

If you need urgent help, call 000. For crisis support, call Lifeline on 13 11 14.

Start Your Pre-Screening

Your Details

Thank you for taking the time.