Confidential Registration
Date Format: DD slash MM slash YYYY
Nb. Include - aspirin, cortisone/steroids, anti-inflammatory, warfarin, herbal products & over-the-counter preparations.
(please tick the areas you are interested in)
Patient Privacy Act
As a result of new privacy laws introduced by the Government, this office requires you to read this sheet regarding your personal and medical information and then sign to say you have read and agree with the statement. Your files contain the following information:
- Personal details (name, address, date of birth, Medicare number & health details)
- Your medical history
- Notes made during the course of your medical consultation
- Referrals to other Health Service Providers
- Results and reports received from other Health Service Providers
This information is provided by you or arises as a consequence of information provided by you. It may be necessary for us to obtain copies of reports such as x-rays, pathology and correspondence from other Medical Professionals or confer with Surgical Colleagues or your General Practitioner regarding your medical treatment. Due to changes in the Privacy Act, it has become necessary for us to obtain written consent from each patient in our practice to obtain these records. Please note: Medical records cannot be released without your consent, except when they are required under Law such as a subpoena.