La Trobe Podiatry Clinic appointments Given name * Family name * Date of birth * Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJunJulAugSepOctNovDec Year 192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018 Daytime contact phone number * Email * Additional information Validation Confidentiality All information provided will be treated as confidential. At La Trobe University, we respect the privacy of your personal information. We collect personal information in your appointment in order to handle your enquiry. In accordance with privacy laws, personal information about you contained in your enquiry will not be used for any other purpose. You may have the right to access personal information we hold about you, subject to any exceptions in relevant laws, by contacting the Podiatry Clinic on (03) 9479 5831. The La Trobe University privacy policy can be viewed at: www.latrobe.edu.au/privacy/
