Patient Registration Form

Privacy Information

In accordance with Government regulations, we are obliged to inform you that a confidential file, containing results of your tests and other relevant information will be archived by us.  Routinely, information regarding the outcome of your consultations with your identifiable details (Name, DOB, Medicare Number, Contact Details) will be forwarded to your referring doctor and we may need to collect and/or send information to/from other treating doctors, specialists, allied health professionals, MHR (My Health Records) and other third parties who is/are involved or/and will be involved in your care.

Our preferred means of communications with you, your treating doctors, specialists, allied health professionals and other third parties who are involved or/and will be involved in your care are via efaxing, MHR (My Health Records), emails, SMS and other Medical Platform Software Provider example HealthLink.

We may need to disclose your personal information with third parties such as Medicare, Private Health Fund, our Medical Software provider/s, IT, Medical Platform Software Provider example Healthlink, eCommunication providers (efaxing, emails) to help provide you the best possible health care from us.

If a Telehealth consultation is needed, I give permission for my Doctor/s at South Sydney Medical Specialists to conduct this via telephone and/or video (Doxy me) consultation.

Submitting this form states that I have read and consented to the above Privacy Information.