Dr. Kenneth Leong and his medical practice collect health information from you for the primary purpose of providing quality healthcare to you. We ask that you provide us with your personal details and a full medical history as complete and truthful as possible so that we may properly assess, diagnose, treat and manage your healthcare needs. We may use the information you provide for administrative purposes in running the medical practice including billing and compliance with Medicare and Health Insurance Commission requirements. Your health information may be sent to or be accessed by other health practitioners directly involved in your care. Occasionally de-identified clinical material in the form of digital images and videos may be used for teaching purposes to medical students, other specialist trainees and other doctors. Such material will not contain any information that may in anyway identify or link you to the material.
Consent
I acknowledge that I have been informed of the following:
I hereby consent to Dr. Kenneth Leong using the information collected from me, for the purpose outlined. I have read, understood and agree with the Privacy Policy.
I also agree to pay all my accounts on time and before the due date. I will advise the staff if I am unable to pay my account.
I understand that non payment of accounts will result in my account being forwarded for debt collection by an external agency.
I understand that any fees incurred in collection of accounts will be on charged to me.