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Terms & Conditions

We require your consent to collect personal information about you and your partner.  Please read this information carefully, and agree to these terms by checking the tick-box prior to submitting the online patient registration form.

The medical practice collects information from you for the primary purpose of providing quality healthcare.  We require you to provide us with your personal details and full medical history so that we may accurately assess, diagnose, treat and be proactive in your health care needs.  This means we will use the information you provide in the following ways:

  • Administrative purposes in running our medical practice
  • Billing purposes, including compliance with Medicare and Health Insurance Commission requirements
  • Disclosure to other doctors in the practice, and locum doctors for the purpose of patient care and teaching. Please let us know if you do not want your records accessed for these purposes.



I have read the information above and understand the reasons why my information must be collected.  I am also aware that this practice has a privacy policy on handling patient information.

 I understand that I am not obliged to provide any information requested of me, but that my failure to do so might compromise the quality of the health care treatment given to me.

 I am aware of my right to access the information collected about me, except in some circumstances where access might legitimately be withheld.  I understand I will be given an explanation in these circumstances.

 I understand that if my information is to be used for any purpose other than set out above, my further consent will be obtained.

 I consent to the handling of my information by this practice for the purposes set out above, subject to any limitations on access or disclosure that I notify this practice of.

 I give my consent to Dr Devini Ameratunga to contact medical practitioners or other bodies that myself and my partner have consulted to obtain health and other information that may be pertinent to my care.  I authorise these practitioners or bodies to release such information (including sensitive health information) to Dr Devini Ameratunga’s practice as requested.

 I acknowledge I have received, read and understood Dr Devini Ameratunga’s practice information sheet outlining fee structure, handling of results and after-hours care.