feature-main-setup
Home
Key Services
Clinical Services
Medical Assessments
Fitness for Work
Injury Management
Travelvax
Skin Cancer Screening
Specialised Medicals
Physiotherapy
General Practice
Kinetic Bookings
Chief Medical Officers (CMO and MRO)
Health Surveillance
Drug and Alcohol Screening
Drug and Alcohol Screening FAQs
Kinetic Injury Rehabilitation
Hand & Upper Limb Rehabilitation Unit (EKCO)
Safety and Training
Manual Handling
Follow Safe Manual Handling Practices (Accredited)
Manual Handling
Office Workstation Assessor Workshop
Workplace Health & Safety
Drug and Alcohol Collection Training
Whitecard
OSH Supervisors
Health and Safety Inductions
Drug and Alcohol Awareness Training
Physical and Mental Wellbeing at the Workplace
Fatigue Management Training (Accredited)
Stress Management at the Workplace
Alertness Training
Stress Management and Wellbeing at the Workplace (QLD)
Managing Different Personalities in the Workplace (QLD)
Mental Health Awareness (QLD)
Rehabilitation and Return to Work Training (QLD Only)
Rehabilitation and Return to Work Coordinator
Rehabilitation and Return Work Coordinator Re-Certification
Harmonisation – Rehabilitation and Return to Work Coordinator for NSW and Victoria
Frontline Injury Management for Supervisors
First Aid Training
Basic First Aid
Senior First Aid
Occupational First Aid Training
Remote Area First Aid
Resuscitation (CPR)
Advanced Resuscitation Techniques
First Aid Kits
Most Popular Kits
First Aid Kit Calculator
National First Aid Kits
Workplace Reponse
Vehicle First Aid Kits
Trauma First Aid Kits
Farm & Outback First Aid Kits
Foodmax Blues Kits
Snake & Spider First Aid Kits
Family First Aid Kits
Remote First Aid Kits
Eyecare / CPR Kits
Burn Kits
First Aid Kit Audit & Restocking
First Aid Order Form
Health and Wellness
Kinetic Wellness Portal
Workplace Health Assessments
Executive Health Programs
Tune Up Health Fairs
Corporate Health Days
Workplace Wellness Programs
Spinal Health
Fit or Fatigued
Kinetic Energy
Drug Diligence
Cool Heat
Kinetic Toolkit
Fatigue Related Services
Onsite Medical Services
Drug and Alcohol Screening
Drug & Alcohol Screening FAQs
24/7 Dr on Call Service
Flu Vaccinations
Skin Screening
Onsite Doctors
Onsite Medics
Medical Centre Management
Job Role Profiling
Onsite Medical Specialists
Client Setup
Client Account Setup
New Client Account Form
Existing Client Update Form
Diary Direct
Diary Direct Registration
Diary Direct Update Form
Diary Direct Online User Guide
Diary Direct Demo
Premium Bookings
Premium Bookings Registration
Premium Bookings Update Form
Premium Bookings Demo
Kinetic Bookings
Kinetic Bookings Request Form
Kinetic Bookings Update Form
News
National
Western Australia
Queensland
Victoria
New South Wales
Northern Territory
Events
Chevron City to Surf for Activ 2012
Chevron City to Surf for Activ Marquee 2012
Chevron City to Surf for Activ Photo Gallery
Nissan Corporate Triathlon
Kinetic Health Mining City2Surf
Kinetic Mining City2Surf Promo Video
About Us
Key People
National Key People
Key People - Western Australia
Key People - Victoria
Key People - Queensland
Key People - New South Wales
Key Partners
NATA Accreditation
National Footprint
Terms and Conditions
Careers
Positions Open
Job Application Form
Locations
Western Australia
Queensland
Victoria
New South Wales
Northern Territory
Contact Us
Enquiries
Service Quality Feedback
Client Update Information
  1. This form is for new clients applying for an account. For those that wish to update existing account details, please fill in the Existing Client Update Form. Please complete all of the fields below to help us streamline the medical bookings processes. Use next and previous buttons down the bottom to navigate through the form pages.
  2. 1. Business Information
  3. Trading Name*
    Invalid Input
  4. Company/Business Name*
    Invalid Input
  5. Trading Category



    Invalid Input
  6. ACN
    Invalid Input
  7. ABN
    Invalid Input
  8. Industry Type
    Invalid Input
  9. Street Address
    Invalid Input
  10. Postal Address
    Invalid Input
  11. State
    Invalid Input
  12. Postcode
    Invalid Input
  13. Main Telephone
    Invalid Input
  14. Main Fax
    Invalid Input
  15. Year Commenced
    Invalid Input
  16. Number of Employees
    Invalid Input
  17.  
  1. 2. Director / Proprietor / Partner Details
  2. Director / Proprietor / Partner Name 1
    Invalid Input
  3. Director / Proprietor / Partner Address 1
    Invalid Input
  4. Director / Proprietor / Partner Name 2
    Invalid Input
  5. Director / Proprietor / Partner Address 2
    Invalid Input
  6. Director / Proprietor / Partner Name 3
    Invalid Input
  7. Director / Proprietor / Partner Address 3
    Invalid Input
  8.  
  1. 3. Trade References
  2. Reference 1
    Invalid Input
  3. Type of Business
    Invalid Input
  4. Telephone
    Invalid Input
  5. Reference 2
    Invalid Input
  6. Type of Business
    Invalid Input
  7. Telephone
    Invalid Input
  8.  
  1. 4. Invoicing for Medicals, Travel & Company Funded Services
  2. Preferred Billing Name


    Invalid Input
  3. Preferred Delivery Method



    Invalid Input
  4. Accounts Contact
    Invalid Input
  5. Accounts Telephone
    Invalid Input
  6. Accounts Fax
    Invalid Input
  7. Accounts Email
    Invalid Input
  8. Invoice Address
    Invalid Input
  9. State
    Invalid Input
  10. Postcode
    Invalid Input
  11.  
  1. 5. Invoicing for Worker’s Compensation & Injury ManagementServices
  2. Invoicing Details


    Invalid Input
  3. Accounts Contact
    Invalid Input
  4. Accounts Telephone
    Invalid Input
  5. Accounts Fax
    Invalid Input
  6. Accounts Email
    Invalid Input
  7. Invoice Address
    Invalid Input
  8. State
    Invalid Input
  9. Postcode
    Invalid Input
  10.  
  1. 6. Medical Results Report
  2. Prefered Delivery Method
    Invalid Input
  3. Authorised Contact
    Invalid Input
  4. Authorised Contact Phone
    Invalid Input
  5. Authorised Contact Fax
    Invalid Input
  6. Authorised Contact Email
    Invalid Input
  7. Results/Reports Address
    Invalid Input
  8. Results/Report Options




    Invalid Input
  9. Own Paperwork
    Invalid Input
    (Please Note: An additional administration fee is charged when own paperwork is requested)
  10.  
  1. 7. Preferred Kinetic Clinics
  2. WA Clinics
















    Invalid Input
  3. VIC Clinics




    Invalid Input
  4. QLD Clinics






    Invalid Input
  5. NSW Clinics



    Invalid Input
  6. NT Clinics

    Invalid Input
  7.  
  1. 8. Your Information
  2. Your Name
    Invalid Input
  3. Your Position
    Invalid Input
  4. Your Email Address
    Invalid Input
  5. Your Direct Contact
    Invalid Input
  6. 9. Terms and Conditions
  7. Terms and Conditions*
    Invalid Input
  8. 9. Submit
  9.   
Home   »   Client Setup   »   Client Account Setup   »   Existing Client Update Form
Copyright 2012. Kinetic Health Group.