PLEASE COMPLETE THIS FORM within 48 hours of making an appointment with our receptionists
and no later than two full business days prior to your appointment.
The information is absolutely necessary for contacting you, triaging, billing, Medicare, prescriptions and other clinical care.
Staff will not be asked to enter the form into your file at the last minute if time is not available. Prosper Paediatrics will not be responsible for the consequences to you of your late provision of needed information.
In this form, you will be asked if you consent to our important policies regarding privacy, bookings, fees and cancellations, payment policy, use of email, SMS and other communication and contact policies, respect & trust. Please read these before completing your form, as these explain the terms and conditions of engaging with us, with your provider and their provision of services.
If you haven’t already booked an appointment, you can request an appointment online.
If you or your child’s details change (e.g. address, phone numbers, GP, preferred pharmacy, etc), please use this form to update our records.
You can also download the form to printout, complete and send it in via post or email, or ask our receptionists to post or email the form to you.
My Health Record (myHR)
Clinicians in the practice may have access to the My Health Records (myHR) of their patients, if the patient (or their parent/guardian) has not already opted out of having a My Health Record.
Your doctor may therefore view and/or upload to the patient’s My Health Record, unless you ask them not to.
The patient or parent/guardian may:
Ask the doctor not to upload documents/other information to the My Health Record.
Ask the doctor to delete something they previously uploaded.
Set their own privacy and security controls on the My Health Record through myGov. This may include setting a security code to prevent a doctor accessing the myHR unless you provide the code (unless it is an emergency situation).
Delete documents/records from the myHR through MyGov.
Parents can manage their child’s myHR until their child turns 14, at which point their access to their child’s record will be removed. Children aged 14-17 can specially nominate their parents to have access to their myHR if they wish.