Regional Physiotherapy & Sports Injury Clinic
Your Personal Health Information and Health Record may be collected, used and disclosed for the following reasons:
- For communicating with other treating medical professionals
- For follow-up/reminder communication
- For contacting you about services and information relevant to your treatment
- For discussion with third party insurers, Medicare and health insurance providers
- For disease notification as required by law
- For use by all physiotherapists in this practice when consulting with you
- For legal disclosure as required by a court of law.
If you have any concerns or wish to restrict access to your information please discuss these with your physiotherapist or front office staff. This practice adheres to National Privacy Principles (www.privacy.gov.au).
- Your “Informed Consent” is required for all treatment provided by this practice. You may withdraw your consent at any time. Treatment will cease if consent is withdrawn.
- If you become uncomfortable with your treatment at any time please inform your physio.
- All forms of treatment carry some risk. Risks will be explained prior to treatment at which time you may choose to continue or discontinue treatment.
I give consent for treatment. I agree to this consent remaining valid until such time as I withdraw my consent. I give consent for all medical information to be released to relevant parties.
* If you have any queries please discuss this form with your physiotherapist.