Privacy requirements: list persons and contact number who have authority to access your medical/dental/account details.
Personal cheques are not accepted. Payment of consultation is required on date of service. I understand there is a prepayment for further medical treatment and is payable two weeks in advance of procedures. A final itemised account will be issued upon completion of any procedure. Accounts fall due immediately on completion of procedure. If it is not finalised promptly, the debt will be passed on for collection. The patient will be liable for all expenses, costs and/or disbursements incurred in recovering any overdue monies, including debt collection fees, solicitor's fees and legal costs on a full indemnity basis. I consent to verification of Medicare card details. For no gap claims and Medicare bulk billing, I assign my benefit right to the Practitioner who rendered the service.