Waitlist audit form

Queensland Health routinely conducts auditing of waiting lists for Queensland’s Hospital and Health Services. We collect information from you through this online form to ensure your patient contact information held by the Hospital and Health Service is up to date, and that an appointment with the relevant health clinic is still required.

You may not be immediately offered an appointment after completing this form. Please contact your relevant Hospital and Health Service directly to find out about waiting times.

Privacy notice: The personal information you provide in this form is being collected by Queensland Health’s Health Contact Centre for the purpose of confirming whether a health service appointment is still required, and your contact details remain current. The department will provide your personal information to the relevant Hospital and Health Services for this purpose, and if necessary, they may contact you direct regarding your appointment. The department handles personal information in accordance with the Information Privacy Act 2009 and will not disclose your personal information to any other third parties without your consent, unless the disclosure is authorised or required by law. For information about how Queensland Health protects your personal information, or to learn about your right to access your own personal information, please refer to the Queensland Health Privacy Policy.

Get started

If you have any trouble completing this form, please reply to the Queensland Health text message you received, and a staff member from the our Health Contact Centre will call to assist you. These calls will be from a private number. Alternatively, you can contact 13HEALTH (13 43 25 84) and ask to be put through to the Waitlist Auditing Team.


Required fields are marked with an asterisk (*).
The patient this form is being completed for is: *
Are you completing this form on behalf of someone else? * This can include a child in your care, or when acting on behalf of an adult patient.

As you are completing this form on behalf of someone else, please provide your details.

Patient details

Date of birth *
e.g. Dr Citizen – Combined Health Care, Ormeau.
Please provide your GP's address.
Your preferred contact email address.
Please provide the home phone number you can be contacted on. If you do not have one, please write N/A.
Please provide the business hours phone number you can be contacted on. If you do not have one, please write N/A.
Please provide this without spaces, e.g., 0400000000. If you do not have one, please write N/A.
Which phone number do you prefer to be contacted on?
Can we make contact via text (SMS) message? * Answering YES to this question provides the option to receive additional communication via text message. This will not be for all communications as we will still contact via phone call and/or in writing as deemed appropriate.
Please provide your home address.
Is the mailing address different to the home address? *
Please provide the mailing address.
Can we use a next of kin or emergency contact option? * You can nominate a next of kin or emergency contact person on your file. This person may be contacted should we be unable to get in touch with you for any reason.
Please provide the details of the next of kin or emergency contact, including their name, best contact number and address.
Do you identify as Aboriginal and/or Torres Strait Islander? *

Please provide your approximate height and weight

The height and weight will assist us to identify patients who could be considered for outsourcing to another facility within the catchment area of the hospital. If you are unsure, an approximate value is fine, or you can write 0. Please enter a whole number.

Numbers only
Numbers only

Free support to help you quit vaping and smoking

Quitline Queensland provides a free, confidential quit support program. The free program for Queensland Health clients includes multiple counselling calls and up to 12 weeks of nicotine replacement products (e.g. patches, gum, lozenges). These products help reduce withdrawal symptoms when quitting and are mailed directly to your home as a part of the program.

Would you like a call from Quitline? *

Appointment needs

Do you still require an appointment with the specialist at the hospital? * This question refers to the hospital and specialty listed in the text message you received with this form.
Would you like to be offered a phone or video appointment? * Some outpatient appointments can be held by phone or video call, instead of requiring you to attend in person. This will only be available if your doctor thinks this is clinically appropriate for you.
Are you currently able to accept an appointment offer? For example, you do not have any current pending travel commitments, family commitments, or other reasons which would prevent you from attending an appointment in the immediate future.
If required, are you available at short notice? *
How much short notice do you prefer? *
Would you like to be transferred to another hospital in Queensland closer to your home? Please note, if you require a transfer, you will need to obtain a new referral from your GP to the other hospital and this will start the transfer process. Please ensure your new address has been provided earlier in the survey so we can contact the hospital closest to your home regarding the transfer.

Thank you for advising that you have relocated interstate. We will advise the hospital and your referral will be cancelled. If you require treatment, you will need to see your GP in your new state, and they will be able to refer you appropriately. Please click “Submit” below to submit the form.

Thank you for your answer, our team will be in contact with you within the next few days to discuss your response. Please click “Submit” below to submit the form.

Last updated: 29 May 2024