Authority to release personal information to us.
I authorise Dr Ghazanfari to obtain all medical and other information required for my care.
I consent to the release of medical, clinical or other information by any medical practitioner, hospital, clinic, insurance company, Centrelink, the Department of Defence or other organisation that would appear to be relevant Dr Ghazanfari.
I understand that by signing this form it will mean that Dr Ghazanfari and his delegates will be able to ask any person who holds information about you to disclose that information, if that information seems relevant to providing my medical care.
In general, this form will be used to access your medical records in the possession of other Doctors and hospitals.