Appointment Request

Please fill in our online form and we will contact you within 2 working days, with the nearest available appointment slot.

This service is strictly for non-emergency, non-urgent cases and not applicable for Same Day Appointment requests.
For medical emergency, please call 995.

I wish to

Make an Appointment

Referred By *

Private appointment, non-subsidised
Private patient, non-subsidised
-WITH CHAS REFERRAL SUBSIDY FORM
To qualify as a CHAS subsidised referral, patient must present a VALID CHAS CARD and COMPLETED CHAS REFERRAL FORM by referring GP/Clinic. Please include as an attachment in this form.

Impt: Green CHAS card holder referred from CHAS Dental Clinics are not eligible for subsidies.
Subsidised, requires referral letter
Please provide a brief description of your medical condition or symptoms. * View Conditions & Treatments
Preferred Institution *
Please select a Specialty/ Service(Optional)
Preferred Doctor(Optional) View SingHealth Doctors

Is the patient an existing patient of the above institution?

Requestor Name

Patient's Particulars

Please select

NRIC/ Birth Cert *
Full Name* (as per NRIC / Passport)
Contact Number *
Date of Birth *
Day *
Month *
Year *
Gender *
Mailing Address *
Attach Referral Document(s)
Cancel