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Boyne Island Family Medical’s New Patient Form

At Boyne Island Family Medical Centre, we are committed to providing ongoing care of the highest quality, and to uphold the Privacy Act and National Privacy Principles. Below is an outline on how your personal health information may be used or disclosed and information about patient consent and restrictions. 

Our Information Policies

We will retain your personal health information and it will be only used for the purposes for which it was collected or otherwise permitted by law. 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.

When you sign below, you as a patient or guardian are consenting that on obtaining your personal health information it may be used or disclosed by the practice for the following purposes:
  • A follow up reminder/recall notices for treatment and preventive healthcare
  • For accounting procedures and the collection of professional fees
  • 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
  • Accreditation and quality assurance activities are conducted by professionally trained non-treating GP’s and other professionally trained and qualified persons e.g. General Practice Managers
  • For legal related disclosure as required by a court of law
  • For the purpose 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
  • For use when seeking treatment by other doctors in this practice
At all times, we are required to ensure your details are treated with the utmost confidentiality. Your records are very important. We will take all steps necessary to ensure they remain confidential.


New Patient Form

 Boyne Island Family Medical Centre Privacy Policy 
Current as of January 2023 

  • Introduction

    A patient record is a confidential document, this privacy policy is to provide information to you, our patient, on how your personal information (which includes your health information) is collected and used within our practice, and the circumstances in which we may share it with third parties. 

  • Why and when your consent is necessary?

    When you register as a patient of our practice, you provide consent for our GPs and practice staff to access and use your personal information so they can provide you with the best possible healthcare. Only staff who need to see your personal information will have access to it. If we need to use your information for anything else, we will seek additional consent from you to do this. 

  • Why do we collect, use, hold and share your personal information?

    Our practice will need to collect your personal information to provide healthcare services to you. Our main purpose for collecting, using, holding and sharing your personal information is to manage your health. We also use it for directly related business activities, such as financial claims and payments, practice audits and accreditation, and business processes (eg staff training).

  • What personal information do we collect?

    The information we will collect about you includes your:


    • names, date of birth, addresses, contact details 
    • medical information including medical history, medications, allergies, adverse events, immunisations, social history, family history and risk factors 
    • Medicare number (where available) for identification and claiming purposes 
    • healthcare identifiers 
    • health fund details.
  • Dealing with us anonymously.

    You have the right to deal with us anonymously or under a pseudonym unless it is impracticable for us to do so or unless we are required or authorised by law to only deal with identified individuals. 

  • How do we collect your personal information?

    Our practice may collect your personal information in several different ways.

    • When you make your first appointment our practice staff will collect your personal and demographic information via your registration. 
    • During the course of providing medical services, we may collect further personal information. Boyne Island Family Medical Centre does participate in My Health Record should you wish to register.
    • We may also collect your personal information when you visit our website, send us an email or SMS, telephone us, making an online appointment.
    • In some circumstances personal information may also be collected from other sources. Often this is because it is not practical or reasonable to collect it from you directly. This may include information from:
    1. your guardian or responsible person
    2. other involved healthcare providers, such as specialists, allied health professionals, hospitals, community health services and pathology and diagnostic imaging services
    3. your health fund, Medicare, or the Department of Veterans’ Affairs (as necessary). 

  • When why and with whom do we share your personal information?

    We sometimes share your personal information:


    • with third parties who work with our practice for business purposes, such as accreditation agencies or information technology providers – these third parties are required to comply with APPs and this policy 
    • with other healthcare providers
    • when it is required or authorised by law (eg court subpoenas) 
    • when it is necessary to lessen or prevent a serious threat to a patient’s life, health or safety or public health or safety, or it is impractical to obtain the patient’s consent
    • to assist in locating a missing person
    • to establish, exercise or defend an equitable claim
    • for the purpose of confidential dispute resolution process 
    • when there is a statutory requirement to share certain personal information (eg some diseases require mandatory notification)
    • during the course of providing medical services, through eTP, My Health Record (eg via Shared Health Summary, Event Summary).
    • Only people who need to access your information will be able to do so. Other than in the course of providing medical services or as otherwise described in this policy, our practice will not share personal information with any third party without your consent.

    We will not share your personal information with anyone outside Australia (unless under exceptional circumstances that are permitted by law) without your consent.


    Our practice will not use your personal information for marketing any of our goods or services directly to you without your express consent. If you do consent, you may opt out of direct marketing at any time by notifying our practice in writing. 


    Our practice may use your personal information to improve the quality of the services we offer to our patients through research and analysis of our patient data. 


    We may provide de-identified data to other organisations to improve population health outcomes. The information is secure, patients cannot be identified, and the information is stored within Australia. You can let our reception staff know if you do not want your information included. 


  • How do we store and protect your personal information?

    Your personal information will be stored at our practice as an electronic file.

    Our practice stores all personal information securely. 


  • How can you access and correct your personal information at our practice?

    You have the right to request access to, and correction of, your personal information.


    Our practice acknowledges patients may request access to their medical records. We require you to put this request in writing and our practice will respond within 30 days. 


    Our practice will take reasonable steps to correct your personal information where the information is not accurate or up to date. From time to time, we will ask you to verify that your personal information held by our practice is correct and current. You may also request that we correct or update your information, and you should make such requests in writing or in person to the practice.

  • How can you lodge a privacy-related complaint, and how will the complaint be handled at our practice?

    We take complaints and concerns regarding privacy seriously. You should express any privacy concerns you may have in writing. We will then attempt to resolve it in accordance with our resolution procedure. Contact our Practice Manager via email info@boyneislandmedical.com. You will be answered promptly.


    You may also contact the OAIC. Generally, the OAIC will require you to give them time to respond before they investigate. For further information visit www.oaic.gov.au or call the OAIC on 1300 363 992. You can also contact the Ombudsman on (07) 3005 7000

Policy review statement

This Policy is reviewed yearly or as necessary.

Last review date January 2023


Please call us today at Boyne Island Family Medical Centre and talk to our friendly and experienced Doctors.
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