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Swan Hill District Health
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Please allow approximately one hour to complete the information in this link. It is not possible to save and close this portal to come back to it at a later time. We recommend, if you have electronic versions of medication lists, pathology results, medical imaging reports or any other information relevant to your admission to be uploaded, that you have the documents prepared before entering your information.
Name of Admitting Surgeon
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Have you been a patient at Swan Hill District Health before? (including as outpatient)
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No
Yes
Have you been admitted to any hospital (including this one) within the last month?
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No
Yes
If yes, which hospital?
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Hospital Admitted Date
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Hospital Discharged Date
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