1. Male or Female?

  • Male
  • Female

2. Age?

3. How long have you been noticing the discolouration of the toenail?

  • Less than 1 year
  • 1-3 years
  • 5 years plus

4. What percentage of the toe nail is affected?

  • 25%
  • 50%
  • 75%
  • 100%

5. Have you noticed any change to nail bed or any discharge emitting from the nail bed?

  • Yes
  • No

6. Do you play sport regularly or are you a runner?

  • Yes
  • No

7. Have you tried using alternative treatments?

  • Yes
  • No

8. What are your most common footwear practices?

  • Boots
  • Shoes
  • High Heels
  • High Tops
  • Trainers
  • Thongs

9. Is this condition common in your family?

  • Yes
  • No

10. Have you consulted a podiatrist before?

  • Yes
  • No

11. Have you been prescribed Oral or Topical Antifungals by your GP in the past?

  • Yes
  • No

12. Do you have any known allergic reactions?

  • Yes
  • No

13. Are you diabetic?

  • Yes
  • No

14. Are you on any other medications?

  • Yes
  • No

15. Do you have any further health concerns that could compromise your immune system?

  • Yes
  • No

16. Please attach pictures of your nail concern for our podiatrists to assess.

17. Is the information provided accurate to the best of your knowledge? This will help us identify the best course of treatment

  • Yes
  • No

Please advise what day and time would be suitable for a video or phone consultation.

  • Phone
  • Video

Thank you very much, our MNHFP podiatrist will be reviewing your information and we will be in contact with you shortly or please contact us now on 1800 880 160 or 0800 020 055 to discuss right away. Regards MNHFP Client Service Team.

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All information provided is private and confidential and is in complete accordance with our privacy policy.

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Thank You

Thank you for enquiring into our range of tailored cold laser at home podiatry programs to address your nail fungus or other nail health concerns.

A member of our Medical Nail team will be in contact with you in 24 business hours to discuss your personal situation in more detail and to advise of the next best steps.

If you have submitted an online consultation form to be assessed, it is currently under review by our podiatrist and client service team. We will be in touch with you via your selected preference of communication and date and time as per the consultation form.

Please see or quote to our client service team your $200 OFF a program code below or click the link below it.

Discount Code – 200OFFMEDICALNAIL

If you would like to discuss your enquiry or consultation form sooner, please do not hesitate to contact a member of our client service team during business hours.

If you have any further questions or concerns, please contact us on 

Australia : 1800 880 160 

New Zealand : 0800 020 055

International : +61 3 9381 7898

Email: clientservice@medicalnail.com.au

Regards 

Medical Nail Home Fitness Program Client Service Team.