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Colonoscopy Brisbane
Trusted Gut Health Care
Questions? Call (07) 3733 1551

Help us prepare for your upcoming procedure

Welcome to Colonoscopy Brisbane
Registration Form

We're here to make your experience smooth, safe and stress-free. Please complete the patient registration form below so our team has all the information needed to support you throughout your care.

  • GESA-accredited specialist
  • No-gap for insured patients
  • Five procedure hospitals
Register onlineTakes about 5–10 minutes — no account needed.
We confirm your detailsOur team checks your referral and cover. Nothing to pay now.
Book your appointmentAlready booked? You're all set. If not, please contact our rooms to arrange a time that suits you.
Dr Goutham Sivasuthan

Your specialist

Dr Goutham Sivasuthan Australian-trained, GESA-accredited General & Endoscopic Surgeon. One specialist, five trusted locations — the same experienced hands from first consultation to procedure.

Fields marked * are required.

1 · Your details

Do you need an interpreter?

2 · Emergency contact & doctor

Emergency contact

Treating doctor

Do you have a GP referral?

You can email your referral to us, or your GP can send it directly — we'll prompt you after you register.

3 · Medicare & insurance

Do you hold a valid Australian Medicare card?
Are you under 18?
Do you have private hospital health insurance?
Is this a Workcover or third-party claim?

4 · Medical history

This helps us plan your sedation and procedure safely. Everything is encrypted before storage.

Do you have diabetes?
Do you have any allergies or adverse reactions?
Do you smoke tobacco or vape?
Do you drink alcohol?
Have you, or a close blood relative, ever had a problem with an anaesthetic?
Have you been told you have sleep apnoea, or do you snore heavily?
Do you get heartburn or reflux, or food coming back up, even if you take medication for it?
Do you have any loose teeth, dentures, crowns, caps or veneers?

5 · Previous scopes & surgery

Have you had a colonoscopy before?
Have you had an upper endoscopy (gastroscopy) before?
Have you had any other surgeries?

Your booking pathway

This is based on your answers above. Pricing is indicative — our team confirms your cover before anything is booked, and there's no payment to make now.

Answer "Do you have private hospital health insurance?" in Step 3 above and your pathway will appear here.

6 · Consent

Read the policies (cancellation · zero tolerance · health information)

Cancellation policy

Consultations. If you cancel within 48 hours of your appointment, or do not attend, a cancellation fee applies: the lower of 50% of the consultation fee or $100. Further appointments are booked once the cancellation fee has been paid. No fee applies if you are unwell or a doctor advises you not to attend (a medical certificate may be requested), or if we change or cancel your appointment. If you are a WorkCover, DVA or ADF patient, any cancellation fee must be paid by you personally and will not be covered by the third party.

Procedures. Payment for your procedure is due at least 7 days before your admission. If you cancel or move your procedure more than 7 days beforehand, your payment is refunded in full or carried to your new date. Between 7 days and 48 hours beforehand you may move to a new date once at no cost, or ask for a refund; asking for a refund instead of moving costs an administration fee of $150 on private-fee and procedure-package bookings, and never on a no-gap arrangement. If you cancel within 48 hours of your admission time, do not attend, or cannot proceed because your preparation or fasting instructions were not followed, we retain the lower of 50% of your payment or $500 as a genuine estimate of the theatre time that cannot be reallocated at short notice, and refund the balance; we may at our discretion apply the retained amount to a new date. This does not apply if you are unwell or a doctor advises you not to proceed (a medical certificate may be requested), or if the practice, the hospital or the anaesthetist cancels; in those cases you receive a full refund or a free new date. A prepayment cannot be claimed from Medicare or your health fund until your procedure has taken place.

Zero Tolerance Policy

Colonoscopy Brisbane has a zero-tolerance approach to any verbal, aggressive or violent abuse and behaviour towards our doctors, staff or other patients. Abusive behaviour — including offensive language, yelling, verbal insults, physical violence, racial abuse or sexual harassment — will result in the person being required to leave the practice, and may mean care is transferred elsewhere; in extreme cases the police will be called. We have the right to refuse treatment to anyone who threatens the safety of our staff or patients.

Health information release

I give my consent to Dr Goutham Sivasuthan of Colonoscopy Brisbane to contact medical practitioners or other bodies I have consulted to obtain health and other information that may be pertinent to my care, and I authorise those practitioners or bodies to release such information (which may include sensitive health information) to Dr Sivasuthan and the practice. I authorise Dr Sivasuthan to include the medical practitioners I have named in patient correspondence (reports, letters or other means) as applicable to my care.

Your registration goes securely to our team. If you haven't booked an appointment yet, please contact our rooms.

Unable to complete this form online?

Online registration is the fastest way for your details to reach our team. If you genuinely cannot complete it online, our practice staff can give you a printable version to fill in by hand.