Review & Sign Medical Information Authority

I, the above-named participant, or authorised representative provide my consent to Perth Disability Care to request, receive, and share relevant medical, clinical, and health-related information for the purposes of:

• Developing, reviewing, and updating care plans
• Supporting medication management
• Communicating with treating health professionals
• Ensuring continuity of care during changes in health status
• Meeting NDIS reporting and compliance requirements

This authority permits communication and exchange of information with:

• General Practitioners
• Specialists and allied health providers
• Hospitals and emergency departments
• Pharmacies
• Diagnostic and pathology services
• Other NDIS providers involved in my care

This authority is valid for the duration of the participant's current NDIS plan, as recorded in Section 1 (Plan Start Date to Plan End Date), unless withdrawn earlier in accordance with Section 5.

This authority must be reviewed and re-signed at each NDIS plan review or renewal, or sooner if the participant's circumstances, representative, or care needs change.

I understand that:

• Only information relevant to my care and support will be requested or shared.
• I may withdraw this consent at any time by notifying Perth Disability Care in writing. Withdrawal takes effect from the date it is received and does not affect information already lawfully shared before that date.
• Withdrawing consent may affect the ability to provide safe and coordinated support, and any impact on my services will be discussed with me.
• This consent does not affect my right to access and correct my own personal information.

Perth Disability Care handles personal and health information in accordance with the Privacy Act 1988 (Cth), the Australian Privacy Principles, and the NDIS Practice Standards. For full details on how your information is collected, stored, used, and disclosed, please refer to our Privacy Policy Privacy Policy - Perth Disability Care.

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If you have a concern about how your information has been handled, you can contact Perth Disability Care on 0479 041 048 or info@perthdisabilitycare.com.au, or Feedback & Complaints - Perth Disability Care or lodge a complaint with the Office of the Australian Information Commissioner (OAIC) at www.oaic.gov.au.

By signing below, I confirm that I have read and understood this authority, that I am providing this consent voluntarily, and (where applicable) that I hold the authority described in Section 2 to sign on the participant's behalf.