Request an appointment

Do you have a Referral? *You need to either have a valid referral, or blood tests demonstrating iron deficiency (generally ferritin less than 50mcg/L for otherwise healthy individuals). These results should be less than 4 months old.

Do you have a copy of your referral? *

I HAVE a copy I can uploadI DO NOT have a copy of my referral

Please upload your Referral here. *

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I cannot upload it here - I will email it directly

Email referral to referrals@tiic.clinic

Please tell us the name of the referrer so we can obtain a copy of the referral *Who is the referrer for your infusion (please give referrers name and their clinic address)

Do you have blood test results (at least iron studies) *If you do not have a valid referral, you will need to upload blood tests demonstrating iron deficiency or consent us getting them on your behalf. These results should be less than 4 months old.

Upload results *

I HAVE a copy I can uploadI DO NOT have a copy of my resultsResults are in the attached referral

Upload your results here *

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Please upload a copy of your results (PDF, screenshot etc).

I cannot upload the results here - I will email them directly

Email results to results@tiic.clinic

We will need to obtain a copy of your results to assess your eligibility for an iron infusion. We need your consent to do this.

I consent to The Iron Infusion Clinic collecting and using my pathology results by contacting my pathology provider for the purpose of assessing my eligibility for an iron infusion. *

Pathology provider *Please tell us which pathology provider you had your blood test though (i.e Sullivan Nicolaides, QML, 4Cyte, Qld Health etc)

To book directly into our Iron Infusion Clinic, we require either a valid referral or recent blood tests confirming iron deficiency.

If you do not currently have a referral or blood results, but are experiencing symptoms that may be consistent with iron deficiency, such as:

Unexplained fatigue
Reduced exercise tolerance
Restless legs
Headaches
Craving for ice or other crunchy foods
Hair loss

We recommend completing our online iron deficiency screening tool.

Following completion of the screening tool, eligible patients will be provided with a pathology request for blood tests and will then be contacted by our clinic to discuss results and, where appropriate, iron infusion booking options.

Patient Details

First Name *

Last Name *

DOB *

Phone Number *

Email Address

Are you eligible to claim Medicare? *

YesNo

Medicare Number *Patient medicare number

Reference *

Expiry *

Street address *

City *

State *

Postcode *

Gender (for medical care) *

Are you currently pregnant? *

YesNo

How many weeks pregnant are you today? *

Appointment Type

Which is your preferred location to be seen? *

Brisbane West (Sinnamon Park)Gold Coast (Ashmore)Toowoomba (St Andrew's)

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