As an enrolled patient at Burwood Health, it is important that we keep your details up-to-date and accurate. Updating Patient Details Your Name * Your Name First Name First Name Middle Name Middle Name Last Name Last Name Preferred Name * Date of Birth * Address * Address Address Address City City Region Region Postcode Postcode Gender * please selectFemaleMaleAnother GenderNot Stated Assigned Sex * please selectFemaleMaleIndeterminateUnknown Email * Confirm Email * Your Phone * Do you wish to register for MyIndici Portal * Yes No Captcha Submit If you are human, leave this field blank.