Welcome to ERH Associates and thank you for completing this form.
Privacy and Confidentiality
We will respect your privacy and keep confidential all the information you give us by following the Privacy Act 2020 and Health Information Privacy Code 1994. We also collect and store all patient information in accordance with our privacy policy https://erhassociates.co.nz/privacy
Use of Health Information
As part of consultation and treatment, you agree that we may disclose relevant personal and health information:
• To service providers such as pathology labs, radiographers and allied health professionals
• Where it is required by regulations, such as to an ethics committee.
• Your medical records may be read by external auditors in the process of accreditation and certification of ERH Associates. The auditors agree to preserve patient confidentiality and privacy. Non-identifying information may be used for analysis and improvement.
Use of non-health information
We may give your name and address to another party for debt recovery, but only to the extent necessary for that purpose.
Confidentiality and Access to Information
• All members of our team, including administrative staff, sign the same confidentiality agreements and are bound by the same ethical and legal standards as our clinicians. As part of their day-to-day responsibilities—such as managing appointments, correspondence, receipt of referrals and results etc —admin staff may have access to your health information. This is a normal and essential part of ensuring smooth and effective care.
• Please also note that your doctor may sometimes discuss your case with other clinicians within the practice if a second opinion or consensus opinion would support the best possible care. This is part of standard medical practice and is done with professionalism and discretion, always with your wellbeing as the priority.
In signing this registration form you agree to:
• Respect the privacy of others by not talking about people you may see or hear in the clinic
• Make any complaints you may have via the appropriate avenues and not in any public forums. Depending on the level of concern, appropriate avenues for complaint may include an email via the secretary/practice manager or the Health and Disability Commisioner. We value our reputation and may press charges against any attempts to publicly defame us.
Keeping in contact with ERH Associates
It is your responsibility to keep us updated on your contact details and we ask you to use an email address that is unlikely to change as circumstances change. Please notify ERH Associates of every change in writing. It is important that we are able to contact you regarding results and other aspects of treatment.
Expectations in the doctor-patient relationship
We need to put certain procedures in place to ensure smooth running of the service and safe provision of services. These are updated in the FAQs about appointments
We may update these from time to time as needed. By signing this form, you agree to service provision according to our practice procedures and policies.
We do not tolerate abusive or threatening behaviour of any kind, whether physical or verbal towards any of our staff. In the event that the therapeutic relationship breaks down, we reserve the right to terminate the therapeutic relationship and the provision of all services and will make recommendations for other options for your care for your GP to consider and coordinate.
Expectations for an Appointment
Appointments at ERH Associates are offered in good faith after review of your referral or request. While we will always aim to explore whether there are further investigations or treatments that may be helpful, we can not guarantee that additional options will be available beyond what your previous doctors have considered. In some cases, the main benefit of your appointment may be reassurance that nothing has been missed and guidance on the most appropriate next steps.
Fees for Appointments
I have read and understood the Cover Letter, which outlines the information about our charging structure – including costs for scripts, Telehealth appointments and emails regarding medical queries. In the event of non-payment on the day of an in-person appointment, you will receive up to two emails reminders after which time the bill will be passed onto a debt collection agency, you will be responsible for any additional fees incurred.
Late Cancellations (within 4 working days)
We charge a non-attendance or late cancellation/late reschedule of an appointment within 4 working days of a scheduled appointment of 50% charge. The fee is to cover the overhead costs and preparation associated with reserving that appointment slot.
Please remember before you cancel your appointment that we do not provide medical advice via email or phone without an appointment and that we have quite a long waiting list for appointments at present.
Travelling for an Appointment
If you are travelling from out of town for an in-person appointment, please note that in the rare event your clinic needs to be cancelled at short notice due to an emergency or your doctor being unwell, we will do our best to arrange for you to be seen by your doctor or another available clinician while you are in Auckland. However, this cannot be guaranteed, and the default arrangement will be to rebook a virtual consult at a mutually convenient time.
Declaration
I have understood all of the above and have had the opportunity to ask questions about them to my satisfaction. I know I can change the information I have recorded in this registration form by contacting the clinic. I can ask for a copy of this registration form if I wish.