Visitors to the Emergency Centre
Family and friends are welcome to join you at the Emergency Centre during your visit. Visitors may be asked to leave the patient when medical staff are consulting with the patient or performing procedures.
Consent to use your private information
Example of our privacy consent form
Toowoomba Private Emergency Group Pty Ltd would like you to indicate whether or not you consent to the use of your personal information for the purposes described below.
You are under no obligation to provide consent to the use of your personal information.
If you do not consent to any of the purposes below, please indicate this by circling the “DO NOT CONSENT” line when signing the Financial Consent Form given to you with this form.
In the event that you do not consent, we will respect your wishes and will not use your information. Please note however that this will mean the emergency doctor will NOT be able to request blood tests, pathology tests, refer you for specialist treatment, advise your general practitioner of your visit or discuss your condition with your family members.
Please indicate if you consent to the use of your personal information for the purposes described below by circling “CONSENT” and dating the Financial Consent Form where indicated.
I hereby consent to the use of my identifiable personal information for the purposes indicated below.
To assist other medical practitioners (such as my GP or medical specialist) or institutions (such as the radiology or pathology departments) who may treat me now or in the future but only to the extent necessary to treat the particular condition that I have consulted the emergency department about. This may include a requirement to forward relevant past medical history.
To inform my “next of kin” (identified by me) of the outcomes of treatment or to obtain consent to necessary treatment when I am not able to provide such consent.
I hereby consent to the use of unidentifiable information about my condition for the purpose of medical auditing, research and teaching.
(For example, if you have a broken wrist, we need to audit how many broken wrists our department treats per month. If you have a heart problem, your (unidentifiable) pathology results may be discussed as part of our ongoing medical education process or we may use your (unidentifiable) x rays to teach medical students or other doctors. In all of these cases, no one knows that you are the patient because all personal data is removed – it is just an x-ray or pathology test with no name)
Your signature contained on the Financial Consent Form will also authorise our emergency department to use this information as stated above for subsequent visits unless otherwise stated.