Pending New: Collection Statement, Consent Form and Privacy Policy


Next Practice – Patient Informed Consent

Next Practice is a network of medical practice clinics. References to Next Practice is a reference to Next Practice and the Next Practice Clinics you intend to visit.

Collection Statement

Next Practice collects information that is necessary and relevant in order to provide you with medical care, treatment and to manage our clinics. This information may include your name, address, date of birth, gender, health information, family history, credit card and direct debit details and contact details.

This information may be stored on our computer medical records system and/or in hand written medical records. Wherever practicable we will only collect information from you personally. However, we may also need to collect information from other sources such as treating specialists, radiologists, pathologists, hospitals and other health care providers. We collect information in various ways, such as over the phone or in writing, and in person at our Next Practice clinics. This information may be collected by medical and non-medical team members. In emergency situations we may also need to collect information from your relatives or friends. We may be required by law to retain medical records for certain periods of time depending on your age at the time we provide services.

Consent

Next Practice requires your consent to collect your personal and health information.

I understand by agreeing to this information that Next Practice is authorised on my behalf to use my relevant personal health information and I am free to withdraw my consent at any one time by written notification.

Next Practice collects information for the primary purpose of providing exceptional health care. It is required that you as the patient provide us with your personal details and a full medical history to allow us to accurately assess, diagnose, treat and advise on all your health care requirements. By clicking YES to this form you give consent for this information to be used by Next Practice in the following ways:

o I give my permission for my personal and health information to be accessed by team members of Next Practice and to be used for administrative purposes to assist in the running of Next Practice, including the sharing of this information with others involved in my health management, such as treating doctors and specialists, allied health professionals and any other implicated parties that may need access to this information to manage my health (within and outside Next Practice). This may occur through referrals to other doctors and/or allied health professionals, for medical tests and in the reports or results returned to my doctor following referrals.

o I give my consent for disclosure for research and quality assurance activities to improve individual, community health care and practice management. This may occur when Next Practice incorporates patient health records into de-identifiable patient information to transfer to a third party, normally used for quality improvement projects.

o I give my consent to allow Next Practice to transfer my personal and health information to third parties who require this information to manage my health for continuity of care.

o I give my consent for other Next Practice clinics to be able to access my personal and health information should I decide to visit a Next Practice clinic in a different location.

o I give my consent to the presence of a third party to be present during my consultation. This may include a patient advocate, general practice nurse, registrar or medical student.

o I give my consent to be part of the Clinic’s National, State and Territory recall and reminder systems.

o I give my consent for Next Practice to send me reminders to help maintain my health for procedures such as vaccinations, cervical screening, bowel screening, breast screening etc.

o I give consent for my data to be sent to various disease specific registers, (e.g. cervical, bowel, breast screening and the Australian Childhood Immunisation register etc) to assist with preventative health management.

o I give consent for the Next Practice clinic I am visiting to process any Medicare claims related to my visit.

I understand by agreeing to this information above that Next Practice is authorised on my behalf to use my relevant personal health information and I am free to withdraw my consent at any one time by written notification.

By clicking YES you are consenting to the information contained within and the Next Practice Privacy Policy which is located on our website. To opt out please contact your Patient Advocate at your Next Practice clinic.

Subscription Model | Terms and Conditions and Consent

Some Next Practice clinics may make available a subscription model to patients. For more information on a clinic's specific Subscription Model Terms and Conditions please contact the clinic to request a copy or visit the clinic's website for further information.

If you subscribe to a subscription model that requires direct debit payments then you are agreeing to the below Direct Debit Terms and Conditions.

Direct Debit Terms and Conditions

This is your Direct Debit Service Agreement. It explains what your obligations are when undertaking a Direct Debit arrangement with us. It also details what our obligations are to you as your Direct Debit provider.

Definitions

agreement means this Direct Debit Request Service Agreement between you and us.

banking day means a day other than a Saturday or a Sunday or a public holiday listed throughout Australia.

debit day means the day that payment by you to us is due.

debit payment means a particular transaction where a debit is made.

direct debit request means the Direct Debit Request between us and you.

you means the customer who has signed or authorised by other means to participate in one of the subscription models.

1. Debiting your account

1.1 By signing this form, commencing on the subscription model or by entering your payment details, you have authorised us to arrange for funds to be debited from the card details provided. Please note that we do not store your payment details. All payment details are stored with our payment provider, PayDock, whose Privacy Policy can be found at the following link. https://paydock.com/privacy/

1.2 We will only arrange for funds to be debited from your card/account once you have signed up to a subscription model.

1.3 Payments will be debited monthly.

1.4 Surcharges may apply.


2. Amendments by us

We may vary any details of this agreement at any time and will notify you of changes.



3. Amendments by you

You may change* your payment details by contacting us directly to adjust your card details.

4. Your obligations

4.1 It is your responsibility to ensure that there are sufficient clear funds available in your account to allow a debit payment to be made in accordance with the terms and conditions of the subscription model.

4.2 If there are insufficient clear funds in your account to meet a debit payment:

(a) you may be charged a fee;

(b) you may also incur fees or charges imposed or incurred by us; and

(c) you must arrange for the debit payment to be made by another method or arrange for sufficient clear funds to be in your account by an agreed time so that we can process the debit payment.

4.3 You should check your account statement to verify that the amounts debited from your account are correct

5 Dispute

5.1 If you believe that there has been an error in debiting your account, youshould notify us directly and confirm that notice in writing with us as soon as possible so that we can resolve your query more quickly.

5.2 If we conclude as a result of our investigations that your account has been incorrectly debited we will respond to your query by arranging this to be rectified.

5.3 If we conclude as a result of our investigations that your account has not been incorrectly debited we will respond to your query by providing you with reasons and any evidence for this finding in writing.

6. Accounts

You should check:

(a) your card and payment details which you have provided to us are correct by checking them prior to confirming; and

If you have any questions prior to providing your payment details, please speak to a member of the practice team.


7. Confidentiality

7.1 We will keep any information confidential. We will make reasonable efforts to keep any such information that we have about you secure and to ensure that any of our employees or agents who have access to information about you do not make any unauthorised use, modification, reproduction or disclosure of that information.

7.2 We will only disclose information that we have about you:

(a) to the extent specifically required by law; or

(b) for the purposes of this agreement (including disclosing information in connection with any query or claim).





By clicking YES you are consenting to the above information, inclusive of patient informed consent, terms and conditions and direct debit conditions. To opt out please contact your Patient Advocate at your Next Practice clinic.

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