Patient Email & SMS Consent

Paperwork Available Here

Gold Coast Heart Centre Patient Email & SMS Consent

What to Do


Download the Patient Email & SMS Consent found below. When you've completed the form, please submit it to our reception desk via email or bring a hard copy to your upcoming appointment.
Patient Email & SMS Consent

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PATIENT DETAILS


SMS CONSENT

Our practice uses an SMS reminder system to assist in the management of your appointments.    Do you consent to the transmission of SMS (mobile text messages), for the purposes of:

Yes
No
Yes
No
Yes
No
Yes
No
Yes
No

You may withdraw your SMS consent at any time by notifying our practice in writing.  


EMAIL CONSENT

I consent to disclosing my medical records to medical practitioners, hospital departments and other providers directly involved in my health care management outside of this practice, by email.


I consent to corresponding with the Administration Staff at Gold Coast Heart Centre by email regarding any upcoming appointments, referral reminders and general administrative and accounting purposes.


I am aware that by sending my medical records via email and corresponding with administration at Gold Coast Heart Centre, that there may be a risk (as with any other document) that it could be read by someone other than the intended recipient.


I am aware that at any time I can withdraw my consent in writing.

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