Dear patient
We value your privacy. All information about you, held in this practice, is kept in the strictest confidence. With the introduction of the Privacy Act Amendment (2000) in December 2001 we remain committed to protecting your privacy and are now asking for your express consent for the use and disclosure of your personal health information in the course of your health care. This consent allows those involved in your health care access to the information necessary to continue the high standard of health service you have come to expect of us.
This information is also for billing purposes, including compliance with Medicare and Health Insurance Commission requirements. We cannot do referrals, scripts or order investigations that have your private details on it without this consent. Disclosure to other health care professionals involved in your health care may include other treating doctors and specialists outside this medical practice that we have referred you to or who require information to complete your care. This includes Pathology, x-rays and other medical tests, pharmacies, hospitals, physiotherapists, podiatrists, psychologists, other doctors in this practice, nursing and reception staff.
Your file will never be released from this surgery without your signed consent ie: other medical practices or insurance purposes.
CONSENT FOR
USE AND DISCLOSURE OF PERSONAL HEALTH INFORMATION
IN THE DELIVERY OF HEALTH SERVICES
I consent to the use of my personal health information by the above-named practice and other health providers involved in my medical treatment and health care.
I have read and agree to the above mentioned Policies and Procedures regarding Pulse Holistic Medical Centre.