PATIENT DETAILS:

RELEVANT MEDICAL CONDITIONS: (must be completed)

MEDICARE / PRIVATE HEALTH FUND / PENSION / VETERANS AFFAIRS DETAILS:

FEE POLICY: THE POLICY OF THIS PRACTICE IS PAYMENT ON DAY OF CONSULTATION

Standard Fees apply, please contact us for details on 03 9421 5044

PRIVACY POLICY:

From 21/12/2001, the Federal Privacy Act of 1988 has been amended to apply to all doctors in private practice. The National Privacy Principles (NPP’s) require that fully informed voluntary consent is obtained before or as soon as practical after the collection of health information. Medical care requires full knowledge of patient health information by all members of a medical team. Your information may be shared with other health providers from time to time. This may include referring doctors, pathology laboratories, radiology practices, anaesthetists, other health providers and debt collection agencies. Some information may also be provided to Medicare and private health funds, if relevant, for billing and Medicare rebate purposes. Health information may be used for “secondary purposes” such as auditing surgical results, clinical research etc. These activities should be a normal part of a good surgical practice. Record keeping for orthopaedic surgery may also include radiographs and clinical photographs. The privacy of individual patients is strictly maintained when reporting results of audits or research to the profession. You may request access to your records. A copy of our privacy policy is available upon request. Please discuss concerns about the privacy of your personal information with Mr Ton.