ENT Brisbane: New Patient Form

New patients are asked to complete a Patient Information form. You can do this online or when you arrive at the practice.

    Terms & Conditions

    I have read the information above and understand the reasons why my information must be collected. I am also aware that the practice has a privacy policy on handling my patient information.

    I understand that I am not obliged to provide any information requested of me, but that my failure to do so might compromise the quality of the health care treatment given to me.

    I am aware of my right to access the information collected about me, except in the circumstances where access might legitimately be withheld. I understand I will be given an explanation in these circumstances.

    I agree to disclose my medical information from other doctors in other practices to this practice.

    I consent to the handling of my information by this practice for the purposes set out above, subject to any limitations on access or disclosure that I notify this practice of.

    I consent to the disclosure of information pertaining to my appointments and outstanding accounts being given to the next of kin provided.

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