Waitlist audit form

Queensland Health routinely conducts auditing of waiting lists for Queensland’s Hospital and Health Services. The purpose of this online form is to ensure your patient contact information held by the Hospital and Health Service is up to date, and that the procedure with the relevant health clinic is still required.

You may not be immediately offered an appointment after completing this form. Please contact your relevant Hospital and Health Service directly to find out about waiting times.

Privacy notice: The personal information you provide in this form is being collected by Queensland Health’s Health Contact Centre for the purpose of confirming whether a health service appointment is still required, and your contact details remain current. The department will provide your personal information to the relevant Hospital and Health Services for this purpose, and if necessary, they may contact you direct regarding your appointment. The department handles personal information in accordance with the Information Privacy Act 2009 and will not disclose your personal information to any other third parties without your consent, unless the disclosure is authorised or required by law. For information about how Queensland Health protects your personal information, or to learn about your right to access your own personal information, please refer to the Queensland Health Privacy Policy.

Get started

If you have any trouble completing this form, please reply to the Queensland Health text message you received, and a staff member from the our Health Contact Centre will call to assist you. These calls will be from a private number. Alternatively, you can contact 13HEALTH (13 43 25 84) and ask to be put through to the Waitlist Auditing Team.


Required fields are marked with an asterisk (*).
The patient this form is being completed for is: *
Are you completing this form on behalf of someone else? * This can include a child in your care, or when acting on behalf of an adult patient.

As you are completing this form on behalf of someone else, please provide your details.

Patient details

Date of birth *
e.g. Dr Citizen – Combined Health Care, Ormeau.
Please provide your GP's address.
Your preferred contact email address.
Please provide the home phone number you can be contacted on. If you do not have one, please write N/A.
Please provide this without spaces, e.g., 0400000000. If you do not have one, please write N/A.
Which phone number do you prefer to be contacted on?
Please provide your home address.
Is the mailing address different to the home address? *
Please provide the mailing address.
Would you like to choose a next of kin or emergency contact to put on your file? * This is a person we can call if we can’t reach you, and it helps us contact you about your procedure. We will not ask this person to make any decisions for you.
Please provide the details of the next of kin or emergency contact, including their name, best contact number and address.
Do you identify as Aboriginal and/or Torres Strait Islander? * The hospital asks this question to help you receive culturally appropriate care and support.
Do you need cultural support? *

Please provide your approximate height and weight

The height and weight will assist us to identify patients who could be considered for outsourcing to another facility within the catchment area of the hospital. If you are unsure, an approximate value is fine, or you can write 0. Please enter a whole number.

Numbers only
Numbers only
Do you currently smoke? *

Free support to help you quit vaping and smoking

Quitline Queensland provides a free, confidential quit support program. The free program for Queensland Health clients includes multiple counselling calls and up to 12 weeks of nicotine replacement products (e.g. patches, gum, lozenges). These products help reduce withdrawal symptoms when quitting and are mailed directly to your home as a part of the program.

Would you like a call from Quitline? *

Procedure needs

Do you still need the procedure at the hospital? * This question refers to the hospital and procedure listed in the text message you received with this form.
If you have trouble doing everyday tasks because of a long-term health condition, impairment or disability, which of the following describes the condition? * Mark all that apply. Note: this is for administrative purposes only, not for medical treatment.
Are you an NDIS (National Disability Insurance Scheme) participant? *
For example: wheelchair access, help with public transport, or have a service animal?
Do you have someone who can pick you up and stay with you after your procedure? *
Are you currently able to accept an appointment offer? * For example, you do not have any current pending travel commitments, family commitments, or other reasons which would prevent you from attending an appointment in the immediate future.
Are you available at short notice (less than 7 days)? *
What is the shortest amount of notice you need before we offer you a procedure date? *
For example: Nov 1 - Nov 15, travelling for work
If deemed appropriate by your treating doctor, would you like to be transferred to another hospital in Queensland closer to your home? Within Queensland, interhospital transfers are available for Queenslanders on procedural waiting lists for some specialities. To be transferred, you need to ensure you information is correctly filled out above, and the hospital will then request a transfer on your behalf. You will be advised of an outcome.

Thank you for advising that you have relocated interstate. We will advise the hospital and your case manager will be in contact. Please click “Submit” below to submit the form.

For example: your symptoms have gotten better.
Thank you for your answer, our team will be in contact with you within the next few days to discuss your response. Please click “Submit” below to submit the form.

Last updated: 28 April 2026