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Privacy Policy

Privacy Statement

Welcome to Station Road Medical Centre Booval Ipswich

To enable ongoing care and total quality improvement within this practice, and in keeping with the Privacy Act 1988 and Australian Privacy Principles (APPs), we wish to provide you with sufficient information on how your personal health information may be used or disclosed and record your consent or restrictions to this consent.

Our doctors and staff are required to sign a confidentiality agreement at commencement of working at the practice, and are also given training in this area at induction, so that they understand how to protect your privacy. Your personal health 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 personal health 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 and health insurance details, data collected from observations and conversations with you, and details obtained from other health care providers (e.g. specialist correspondence) or third parties. Your health information can also include information that you provide to us regarding your social and family history because it is relevant to your ongoing health management.

By signing below, you (as a patient/guardian) are consenting, that on obtaining your personal health information it may be used or disclosed by the practice for the following purposes:

  • Follow up reminder/recall notices for treatment and preventive healthcare, and appointment reminders using phone numbers provided by you. You may inform us if you do not want voice messages relating to appointments left on message banks. When you provide us with a mobile number, we accept this as your consent to use this to deliver SMS appointment reminders, or leave messages, unless you tell us otherwise.
  • For use when seeking treatment by other doctors in this practice, as this is a group practice using shared electronic records.
  • The diagnosis and treatment of any health condition, including the communication of relevant information only, to practice staff, specialists and other healthcare providers to ensure quality care is provided.
  • For practice accounting procedures and the collection of professional fees, both internally and via debt collection services. Only name and contact details and the outstanding invoices will be disclosed.
  • Accreditation and Quality Assurance activities are conducted by professionally trained non-treating GP’s and other professionally trained and qualified persons e.g. Nurses and Practice Managers.
  • For legal related disclosure as required by a court of law, child protection agencies or in response to a subpoena.
  • For third party requests by organizations such as insurance companies and lawyers. Such requests can occur when you are making an insurance claim on a policy, when you are applying for a new policy or have engaged a legal representative to act on your behalf. Such disclosure is only made when you provide an authorisation (may be an electronic signature) to the insurance company or lawyer for us to release information. Often such requests are for the whole medical record and may include information that is not directly related to your claim.
  • Workers Compensation matters. When you have a claim under workers compensation, it is a legal requirement that any treating doctor who writes WorkCover medical certificates for you must provide information when requested, to the Workers Compensation Organization- this may be done verbally, in a written report or with provision of part or whole medical records.
  • For the purposes of research only where de identified information is used.
  • To allow medical students and staff to participate in medical training/teaching using only de identified information.
  • For disease notification as required by law.
  • Where you are unable to act on your own behalf due to a health condition, we may need to discuss your health information with relatives or emergency contacts, in order that you are provided with appropriate care.
  • We will not send your medical information to anyone overseas, unless you specifically consent for us to do so, or it is a requirement by law.
  • If you interact with us via our website or mobile device app, we will use personal information that you give to make an appointment when you use the online appointment facility, or we will collect your email address, in order that we can respond to you. There may be links provided in our website that take you to external pages, which are not under our control.

Your may contact the Privacy Officer at Station Rd Medical Centre, with any questions or concerns by phoning or writing to:

The Privacy Officer
Station Rd Medical Centre
50 Station Rd

07 3816 1155

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.

I, ___________________________ give my permission for my personal health information to be

collected, used and disclosed as described above, I understand only my relevant personal health

information will be provided to allow the above actions to be undertaken and I am free to

withdraw, alter or restrict my consent at any time by notifying this practice in writing.

Please note any restrictions to this consent that you wish to apply at this point:




Patient Name: (Please Print)


Signature: ______________________________ Date: ___________

Other family members (Each Patient 16 years or older must sign their own consent) you are signing this consent on behalf of:

Please give name and date of birth for each individual that this consent applies to:

If not Patient signing -Your name (Please Print ) __________________________________________

Your relationship to patient (e.g. Mother, Father, Guardian)__________________________________

PRACTICE USE ONLY: Witnessed by: (Staff Signature)____________________________________