Home
Wealth Services
- Plan
- Protect
- Invest
- Transform
- Organise
Family Office
Insights
Contact Us
Client Login

Home
Wealth Services
Family Office
About Us
Insights
Contact Us

Plan
Protect
Invest
Transform
Borrow
Organise

About Us
Community
Global Partnerships

About Us
Community
Global Partnerships

Our Services
Global Product Range
Investment Platforms
Join Cashel Family Office

CashelFamilyOffice form icon

CashelFamilyOffice form icon

CashelFamilyOffice client icon

CashelFamilyOffice client

Preamium
Hub24

Health Insurance Referral Form

Health Insurance Referral

General Insurance Application
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone Number*
(including country code)
Insurance (Health)
Partners Date of Birth
DD slash MM slash YYYY
Hospital Coverage Level
Extras Cover Level
Income
Excess
What is important to the client?
- Public hospital accommodation
- Private hospital accommodation
- Shared room
- Single room in a private hospital (where available)
- Accidental injury
- Appendicitis
- Cardiac treatments
- Cancel treatment
- Intensive and coronary care
- Joint reconstructions and investigations
- Medical gap cover
- Gynecological procedures
- Neurostimulators
- Operating theatre
- Psychiatric services
- Rehabilitation services
- Removal of tonsils and adenoids
- Spinal Surgery
- Surgical implanted prostheses
- Cataract and corneal transplants
- Dental implant surgery
- Joint replacements including hips and knees
- Pregnancy related services (including childbirth)
- IVF and assisted reproductive services
- Healthy Start benefit (pregnancy related services)
- Gastric banding and all obesity surgeries
- Haemodialysis
- Insulin Pumps
- Hospital in the Home
- Rehabilitation in the Home
- New Family program
- Podiatric surgery
- Palliative care
- Cochlear implants
- Plastic & Reconstructive Surgery
- Blood (harvesting of bone marrow for transplantation)
- Dental
- Optical
- Chiropractic and Osteopathy
- Physiotherapy and Hydrotherapy
- Myotherapy
- Acupuncture
- Naturopathy
- Orthodontics
- Remedial Massage
- Homeopathy
- Ambulance Subscription
- Ambulance Transport
- Exercise Physiology
- Psychology
- Counselling
- Pharmacy
- Travel Vaccinations
- Dietetics
- Audiology
- Antenatal and postnatal classes
- Eye therapy
- Speech therapy
- Occupational Therapy
- Podiatry
- Nursing
- Prostheses (non-surgical)
- Blood glucose monitor
- Extremity pump
- Nebuliser pump
- Sleep apnoea monitor
- Tens monitor
- Hearing aids
- Orthopaedic repairs
- Orthotic appliances (foot)
- Orthopaedic appliances
- Pressure garments
- Weight Management Program
- Fluoride dietary supplement
- Swimming lessons
- Flu Vaccination
- Cancer Council Australia UV Products
- Melanoma Surveillance Photography
- Nicotine replacement patches
- HPV Vaccination

Δ

[email protected]03 9209 9000

Wealth Services

Plan
Protect
Invest
Borrow
Transform
Organise

Family Office

Our Services
Global Product Range
Investment Platforms
Join Cashel Family Office

About Us

About Us
Global Partnerships
Community

Useful links

Privacy Policy
Conflicts of Interest policy
Forms

© 2024, Cashel Family Office (Australia) Pty Ltd, All Rights Reserved.

Issued and maintained by Cashel Support Services Pty Ltd (ABN 31 619 697 808, Authorised Representative Number 001257601 of Cashel Financial Services Pty Ltd, Australian Financial Services License and Australian Credit License No 306803) ('Cashel'). Use of this website is subject to Cashel Financial Service Pty Ltd's Terms and Conditions and Privacy Policy.