Dear Patient, We require your consent to collect personal information about you. ENT Specialist Centre 'the practice' collects information from you for the primary purpose of providing quality health care. We require you to provide us with your personal details and a full medical history so that we may properly assess, diagnose and treat illnesses and be pro-active in your health care needs. The practice may also use the information you provide in the following ways: Correspondence will usually be sent to your referring Doctor and GP if different as required. In the case of a Workers' Compensation or Third Party Claim, personal/medical details may also be released to either the Insurance Company and its representatives and/or your Solicitor with the appropriate authority. Administrative & billing purposes, including compliance with Medicare and Health Insurance Commission requirements. Disclosure to others involved in your health care, including treating Doctors and Specialists outside this practice. Disclosure to other Doctors in the practice, Locums, and by Fellows, Registrars or students attached to the practice for the purpose of patient care and teaching.
Please let us know if you do not want your records accessed for these purposes and we will note it on your record accordingly. Disclosure for research and quality assurance activities to improve individual and community health care and practice management. You will be informed when such activities are being conducted and given the opportunity to "opt out" of any involvement. I have read the information above and understand the reasons why my information must be collected. | am also aware that the practice has a privacy policy on handling patient information. I understand that I am not obliged to provide any information requested of me, but that my failure to do so might compromise the quality of the health care and treatment given to me. I am aware of my right to access the information collected about me, except in some circumstances where access might legitimately be withheld. I understand I will be given an explanation in these circumstances.