Patient Registration

Patient Details

Medical account details

Doctor Details

Emergency Contact Details:


To enable ongoing care and total quality improvement within this practice and in keeping with the Privacy Act (1988) and the Australian Privacy Principles, we wish to provide you with sufficient information on how your personal and health information may be used or disclosed and record your consent or restrictions to this consent. Your personal and health information will only be used for the purposes for which it was collected, or as otherwise permitted by law and we respect your right to determine how your personal and health information is used or disclosed. The information we collect from you may be collected by a number of different methods and examples may include: medical test results, notes form consultations, Medicare and health insurance details, data collected from observations and conversations with you, and details obtained from other health care providers (e.g. specialist correspondence). By signing below, you (as a patient/guardian) are consenting, that on obtaining your personal and health information it may be used or disclosed by the practice for the following purposes: - for follow up reminder/recall notices for treatment and preventive healthcare; - for accounting procedures and the collection of professional fees; - for the diagnosis and treatment of any health condition, including the communication of relevant information only, to practice staff, specialists and other healthcare providers to ensure quality care is provided; - for the referral (or the onboarding) of you to other health care providers as may be agreed between you and us from time to time, and the subsequent use of your personal and health information by those healthcare providers or the diagnosis or treatment of any health condition; Accreditation and Quality Assurance activities conducted by professionally trained non-treating GPs and other professionally trained and qualified persons, e.g. General Practice Managers; - For legal related disclosures as required by Court of Law; - For the purposes of research where de-identified information is used; - To allow medical students and staff to participate in medical training/teaching using only de- identified information; - For disease notification as required by law; - For use when seeking treatment by other doctors in this practice. At all times, we are required to ensure your details are treated with the utmost confidentiality.

We will not discuss medical conditions or appointment information with anyone but the patient (if over 16) without signed consent, this includes spouse and all relatives.

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