Invite a service or service provider

If you would like an LHD service (or staff member), Private Service Provider (allied health, specialist, pharmacy, other) or would like to invite another GP, please fill the form in below.

The recipient email address will receive a copy of this invite, as well as the information pamphlet, and your customised invite message.

If you want to get access to the platform yourself, please sign up from here.

Have you already talked to this provider/someone at this service about this?*

Yes
No

Who are you nominating?*

Business Name*

Key Contact Name*

First Last

Enter the name of the person you would like the invite to be sent to: the person you're inviting, their practice manager, receptionist etc.

Key Contact Email*

Enter Email Confirm Email

We will send the invite to this person.

Contact Phone Number*

Business Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What name the invite will come from*

E.g. Alstonville Clinic, or Dr Joe Blogs

And what email should this come from?*

Enter Email Confirm Email

Yours, your reception, practice manager, etc

Enter your invite text here. We will send this to the recipient, and send you a copy.*