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Privacy Declaration

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Due to Privacy Legislation, we require your consent to collect personal information.

This practice collects your information in order to identify your medical records and provide an accurate, quality health service. This means that we will use the information you provide in the following ways:

I have read the information above and understand the reasons why my information must be collected. I am also aware that this practice has a privacy policy on handling patient information. I understand that I am not obliged to provide any information requested but that my failure to do so might compromise the quality of health and treatment provided to me. I am aware of my right to access the information collected about me, except in circumstances where access might legitimately be withheld. I understand I will be given an explanation in these circumstances. I understand that if my information is used for any other purpose other than that set out above, my further consent will be obtained.

I consent to the handling of my information by this practice for the purpose set out above, subject to any limitations on access or disclosure that I notify this practice of.


I understand that if I withhold relevant information from the practice that my medicare may be affected.

PLEASE NOTE: Due to the privacy laws, results cannot be given to a third party unless written authorization is obtained or under special circumstances.


Privacy legislation - 20/02/2012

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