Medical Pilot Booking Form

Booking enquiry form for Bendigo / Heathcote medical specialist access corridor pilot.

Referring Doctor's Details

Patient Details

Patient's HOME ADDRESS (pickup location)*(Required)

Destination Details

Address for Specialist (dropoff location)*(Required)

Appointment Date and Time (if known)

DD slash MM slash YYYY
Appointment Time (if known)

Special Needs

Choose as applicable
All travel and/or special needs requirements are subject to confirmation by LINK Community & Transport.u000b(additional costs may apply)

To Complete

Please click the "captcha validation" and click submit. We will contact you shortly. Your transport booking, or any special assistance requirements are not final until you have had confirmation from us of our acceptance of your request and our agreement to provide transport. Please use an alternative service if your needs are urgent, emergency, or require medicalised support.
This field is for validation purposes and should be left unchanged.