Enrolment Terms & Conditions

  • I intend to use this practice as my regular and on-going provider of general practice/GP/healthcare services.
  • I understand that by enrolling with this practice, I will be included in the enrolled population with the Primary Health Organisation (PHO) this practice belongs to, and my name, address and other identification details will be included on the Practice, PHO and National Enrolment Service Registers.
  • I understand that if I visit another health care provider where I am not enrolled, I may be charged a higher fee.
  • I have read and I agree with the Use of Health Information Sheet. The information I have provided on the Enrolment Form will be used to determine eligibility to received publicly funded services. Information may be compared with other government agencies, but only when permitted under the Privacy Act.
  • I understand that to support the provision of the best possible care, we may receive information about you from other agencies, either directly or indirectly.
  • I understand that if I provide information about another person as part of the enrolment process, e.g. next of kin, children, that I am responsible for informing them and obtaining their consent to do so. We will assume this consent has been obtained upon signing of this enrolment form.
  • I understand that the practice participates in a national survey about people’s health care experience and how their overall care is managed. Taking part is voluntary and all responses will be anonymous. I can declined the survey or opt out of the survey. The survey provides important information that is used to improve health services.
  • I agree to inform the practice of any changes in my contact details and entitlement and/or eligibility to be enrolled.
  • I agree to the practice collecting, using and sharing my personal and health information as outlined in the Health Information and Privacy Statement and the Green Cross Health Privacy Policy.
  • I understand that the practice is entitled to charge a fee for the health services it provides and that I agree to pay such costs according to the policy of the practice including any additional costs associated with the collection of overdue or unpaid accounts.