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  Query Form

Send a query to MBS billing staff by printing off this form, filling out and faxing to (03) 9329 8846. You can also use this form to request billing sheets.


 

 MEDICAL BILLING SERVICE
 
  Type of Query 
 
  (Circle one)

  General
  Request Billing Sheet
  Registration Inquiry
  Feedback


  Name


  Email address


  Contact Number


  Please circle one:


  Resident  
       
  Visiting

  Specialty


  Location
 


   (Circle one)
   
   VIC  NSW  WA  SA  TAS  ACT  QLD
                                                                                    

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