CONSENT TO COLLECT PATIENT INFORMATION
PRIVACY ACT 1988 • PRIVACY ACT AMENDMENTS-PRIVATE SECTOR-ACT 2000
This medical 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 medical history so that we may properly assess, diagnose, treat and be proactive in your health care needs. We will use the information you provide in the following ways:
• I understand that if my information is to be used for any purpose other than the above, my consent will be sought.