(Please read this consent and agreement carefully prior to sign):
1)I understand that collecting my personal information and medical history is required to ensure high quality healthcare, accurate Medicare/Insurance billing and referral to other specialists or hospitals.
2)I shall inform AIM Health if there are any changes to my contact details, such as address and phone / mobile number. If I am unable to be contacted, I understand that I am responsible for any associated consequences.
3)I consent for AIM Health to send me reminders via SMS, phone call, letter or email.
4)I consent for AIM Health to submit data to diseases registers to assist with preventative health management (e.g. cervical, breast and bowel screening, etc.) and share de-identified information for quality improvement and clinical audit activities purposes.
5)I agree that I need to make an appointment to discuss my results, or obtain referrals, prescription, medical certificate, MHCP, EPC, etc.
6)I understand that AIM Health requires at least 24hrs notice to cancel or reschedule an appointment. Failure to do so may result in a cancellation fee of $40, which needs to be paid within 7 days.
7)I am aware that there will be an administration fee to transfer/obtain my medical records, which needs to be paid upfront, as per the Australian Health Record Regulation.
8)I need to make a longer appointment if I have more than one issue or complex health conditions: e.g. TAC or Workcover (not covered by Medicare), referral for mental health care plan, to allied health providers, EPC referral –as per Medicare / insurance requirements under GP Management, etc.
9)I agree to the assignment of the Medicare benefit directly to the provider unless other arrangement on the day.
