Request Access to Patient History

As a medical practitioner you may request access to our Histopath patient database even if you are not a current referring doctor. This request requires call-back confirmation prior to granting access.

This form must be filled in by the requesting clinician/ specialist/ registrar.
For multiple access requests, please submit a new form for each user.

Please fill in all the fields below and Histopath will be in touch with you within 2 working days.
Fields marked with an asterisk (*) are mandatory.


*For registration and security
*For registration and security

*A security question
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*A security question


For our privacy statement refer to our Privacy Policy

Once we have reviewed and accepted your application, a unique username and password will be provided to access the service. An email containing the username will be sent to the nominated email address from histopath@histopath.com.au and an SMS will be sent with the password to the nominated mobile number.