Patient Consent
We ask you to provide us with your personal details and full medical details so that we can assess, diagnose, treat and provide you with the best possible health care we can. The information you have provided will be used in the following ways:
- Administrative purposes in running our medical practice
- Billing purposes, including compliance with Medicare & Health Insurance requirements
- Disclosure to others involved in your health care, including treating doctors and specialists outside this medical practice.
This may occur through referral to other doctors, or for medical tests and in results returned to us following the referral.
I have read the above information and understand the reasons why information must be collected. I am aware that if I do not have to supply the information requested of me, however my failure to do so may compromise the quality of the health care andtreatment given to me.
I am aware of my right to access the information collected about myself, except in circumstances where access may legitimatelybe withheld. I understand I will be given an explanation in these circumstances.
I understand that if my information was to be used for any other purpose than set out above, my consent will be obtained.
I consent to the handling of my information by this practice for any purposes set out above. I consent to the retrieval of medicalinformation, including reports and results from medical tests from others involved in my care, including treating doctors,specialists, hospitals, health care professionals and facilities outside this practice.