To enable ongoing care and total quality improvement within this practice, and in keeping with the Australian Privacy Principles and Privacy Act 1988, we wish to provide you with sufficient information on how your personal health information may be used or disclosed. By signing below, you (as a patient/guardian) are consenting that on obtaining your persona health information it may be used or disclosed by the practice forthe following purposes:
Follow up reminder/recall noticesfor treatment and preventative health care including email and SMS.
For accounting procedures and thecollection of professional fees.
The diagnosis and treatment ofyour condition, including the communication of relevant informationonly, to practice staff, specialists and other health care providersto ensure quality care is provided.
For legal related disclosuresrequired by the Court of Law.
For disease notification asrequired by Law.
For use when seeking treatment byother doctors in this practice.
For obtaining medical records,previous clinical reports, and management regimes, etc from othermedical practitioners, institutions and laboratories.
To inform the next of kinidentified in my patient information of the outcome of treatmentor to obtain consent to necessary treatment when I am not able toprovide such consent.
To register and upload HealthSummaries (E-Health) to My Health Record. This is an outline summaryof your health information. It can be accessed at any time by youand your healthcare providers. This means that, whether you’revisiting a GP for a check-up, or are in the emergency room followingan accident and are unable to communicate clearly, healthcareproviders involved in your care can access important healthinformation, such as: Allergies, Medications you are taking; Medicalconditions you have been diagnosed with; and/or Pathology andRadiology Reports.
Accreditation and qualityassurance activities to improve individual and community health careand practice management.
Doctor/s at Brendale Family Practiceare also required to participate in research for quality assurance.To enable them to do this, they need permission to use de-identifiedmedical information from patient’s medical records. Should youdecline participation this will not effect or impact on the care youreceive at this practice. Please sign below to give permission foryour doctor to use the de-identified medical data within your medicalrecords for this specific purpose only.
relevant personal information will beprovided to allow the above actions to be undertaken and I am free towithdraw, alter or restrict my consent at any time by notifying thispractice in writing.
Patient/Guardianname/Child under 16 years: (please print) Click Here
Patient Feedback Form
As a way of trying to continually improve our services for patients,we encourage patient feedback. This enables us to see if ant changes/improvements need to be made to our current services to try to meet our patients’ needs. If you have complaints, suggestions or comments on the service you have received, please complete the form below and return it to the reception who will pass the form to the Practice Manager.
Patient Feedback Form
To help us monitor equality for complaints and feedback , pleasecomplete the ethnicity section below