Do you have private health insurance?
Please carefully read the following information about privacy issues and fees structure, then sign this form where indicated below. Privacy issues I understand that Allergy Medik and the doctors and staff within the group comply with the Privacy Act 1988 and as part of their Privacy Policy they are committed to protecting the Privacy of individuals and their personal information. The main reason why information is collected by this practice is so that we can assess, diagnose and treat your illness and be proactive in your health care needs. This means that we will use the information you provide in the following ways:
1.Administrative purposes in running the medical practice
2.Billing purposes, including compliance with Medicare and Health Insurance Commission requirements,
3.Disclosure to others involved in your healthcare, including treating doctors and specialists outside this medical practice. This may occur through referral to other doctors, or for medical tests and in reports or results returned to us following the referrals.
I have read and understand the above privacy conditions. Yes