Patient Registration

  • PATIENT DETAILS

  • Date Format: MM slash DD slash YYYY
  • (Osteopath, Podiatrist, Chiropractor etc)
  • PATIENT HISTORY

  • PATIENT CONSENT

    As a health care provider in the private sector, the Victorian Orthopaedic Group is bound by the Nation Privacy Principals provided in the Privacy Act 1988. These govern how we collect, handle, use, distribute and store personal information collected from our patients at the clinic. Ordinarily we do not release the contents of your file without consent. When dealing with other health care professional, in order to obtain accurate diagnosis or treatment options we will ask your full consent to disclose any personal medical details. Please indicate below and sign your consent for details to be disclosed when necessary.
  • Date Format: MM slash DD slash YYYY