Thank you for giving me the opportunity to join you in your fertility journey.

Communication is a vital part of providing excellent care and you filling in this consent form will allow myself and my team to communicate with you.

We look forward to doing anything we can to help you.

See you soon!

Your Privacy

My medical practice collects information from you for the primary purpose of providing quality care. Providing me with your personal details and medical history allows me to properly assess, diagnose, treat and be proactive in your health care needs. My team will use the information you provide in the following ways:

1. Administrative purposes in running of my medical practice.
2. Billing purposes, including compliance with Medicare and Health Insurance Commission requirements
3. If permitted by you, update any other health professionals involved in your health care on your progress and our plan.

I will make sure that your personal details will remain confidential in accordance with the NSW Privacy and Personal

Information Protection Act 1998. By signing below, you agree that:

• You are happy for me to discuss your medical history, diagnosis, and our management plan with your referring doctor and any other relevant medical specialists as required
• You understand you are welcome to access your medical records at my practice
• You are responsible for and understand the fees associated with your care
• The information you have supplied is accurate

If your information is to be used for any purpose other than the above, your consent will be sought.