*** For Covid-19 vax patients – you do not need to fill in this paperwork or apply to be new patients.

The HotDoc online forms are the only ones necessary for Covid-19 vaccinations ***

There are limited places available for new patients at CCFP and most of our GPs are not accepting new patients.

Please contact our reception prior to completing this paperwork to apply to be a new patient at the practice.

The form asks for information which will help us provide the best quality medical care for you, and it will take about 10-15mins to complete.

We also have copies at reception if you would prefer to pick one up from the clinic, to complete well prior to your appointment.

Other information that you might find useful:

CCFP 2022 Privacy policy

CCFP 2022 Info for patients

CCFP 2022 Services and fees

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New patient registration - over age 16

Thank you for taking the time to complete the following paperwork because it helps us to provide the best possible care for you and your family.
Name (exactly as it appears on your Medicare card)
Date of birth
Address
Email address
Next of kin name
This information helps us to provide appropriate care for a wide variety of people from different backgrounds and ethnicities.
Or enter "No known allergies''
Or enter ''No previous medical conditions''
Or enter "No current medications"
Family history of illness
For example - ages of family members affected.
in centimeters
in kilograms
For example - needle phobia, things we can do to assist you to feel comfortable in our clinic etc.

Health information collection and use consent

We need to record your personal and medical details so that we can create a medical record and provide quality health care to you. We take protecting your personal and medical details very seriously, and you can download a copy of our privacy policy from our website, or request a copy from our reception. We use the information to: provide patient care, run our medical practice, billing including Medicare and Health Insurance Commission compliance, make referrals to other health care providers like other doctors, or pathology companies, instruct any students attached to our practice, for quality assurance activities to improve individual and community health, to comply with legislative or regulatory requirements e.g. notifiable diseases, for reminder SMS/emails/letters/phonecalls which will be sent to you regarding your healthcare and management. If data is used for quality improvement or research purposes the information will be de-identified, in the situation that any identifiable data is needed your consent will be requested.
Please consent to CCFP creating a medical record for you by agreeing to the following items