New Patient Registration

YOUR PRIVACY AND MEDICAL INFORMATION

This medical practice collects clinical and financial information from you for the primary purpose of providing quality health care. We require you to provide us with your personal detailsso that we may properly access, diagnose, and treat your health care needs. This means that we will use the information for administrative purposes, billing, disclosure to others involved in your health care; including specialists and other treating doctors outside this practice and disclosure to other doctors in the practice including locums to assist in your medical care. This practice may occasionally be involved in research and quality assurance activities to improve individual and community health care and practice management. All information is de-identified. If you wish to opt out of any research undertaken by the clinic, please inform your doctor. We wish to always assure you that your health information is treated with utmost confidentiality.

The consultation fee is payable at the end of your consultation. If you choose to have your surgery in the public system, your public surgical booking form will only be sent to the respective hospital after the account has been settled. It will be your responsibility to communicate with the public hospital elective surgical booking office regarding the time of your surgery.

FINANCIAL CONSENT

REGISTRATION FORM