PLEASE ENTER YOUR NAME EXACTLY AS IT APPEARS ON YOUR PASSPORT( FOR TRAVELLERS) OR MEDICARE CARD

If you have been tested here before and would like to change any of your details, e.g: address or mobile number, you could write them below.

This information is used for various reporting purposes

What happens after Covid-19 test?

• You must go straight home and self-isolate until you receive your negative result.
• One of our doctors may call you in a few days to discuss the management of your symptoms and to see how you are going even if your test result is Negative.

Attention:

If you do not receive your result within 48 hrs of swab collection via a text message,  you may call Australian Clinical Labs on: 1300 134 111 . Please do not call earlier than 48 hours for your result.

This clinic collects information from you for the primary purpose of providing quality health care. We require you to provide us with your personal details and medical history so that we may properly assess, diagnose and treat illnesses. To enable ongoing care, and in keeping with the Privacy Act 1988 and Australian Privacy Principles, we wish to provide you with enough information on how your personal information may be used or disclosed and record your consent or restrictions to this consent.

Your personal information will only be used for the purposes for which it was collected or as otherwise permitted by law, and we respect your right to determine how your information is used or disclosed. The information we collect may be collected by a number of different methods and examples may include: medical test results, notes from consultations, Medicare details, data collected from observations and conversations with you.

By consenting below, you (as a patient/parent/guardian) are consenting to the collection of your personal information, and that it may be used or disclosed by the practice for the following purposes:

Administrative purposes in the operation of our clinic.

Billing purposes, including compliance with Medicare requirements.

Follow-up notices

Disclosure to others involved in your health care, including treating doctors outside this clinic.

For legal related disclosure as required by a court of law.

To comply with any legislative or regulatory requirements, e.g. notifiable diseases.

For use when seeking treatment by other doctors in this clinic.

At all times we are required to ensure your details are treated with the utmost confidentiality. Your records are very important, and we will take all steps necessary to ensure they remain confidential.

• • Covid-19 test for overseas travellers is not free, we charge $100 on weekdays and $120 over the weekends. Please talk with our receptionist to arrange payment.

    I understand that apart from what I pay today to Covid Testing clinic, I might receive another invoice from clinical lab pathology later for the cost of processing the PCR swab. I know that travel tests are not eligible for a Medicare rebate.

    Informed Consent:

  • I understand that I was advised to do the Covid-19 test 48 hours prior to my departure, (We prioritise testing for travellers and 99 percent of the time, your result will be ready in 24 hours).
  • I understand that this is my sole responsibility to check with my airline or travel agent for the timing of doing Covid-19 test and the advice I was given by Covid-19 staff is only general advice.