Title Surname First Name Address City State Postcode Home phone Work phone Mobile phone Email Date of birth Occupation
Name Phone Number Relationship
Dr Lawrence Kim may, on occasion, wish to communicate with you by email. All email communications are performed with particular regard to the privacy and confidentiality of your health information, however, email communication is NOT ENCRYPTED, and therefore carry a higher risk. Email does not replace other forms of communication with your practitioner, such as consultation visits. Consenting to communicate with us by email assumes the following:
You acknowledge that the privacy and confidentiality of your health information may be compromised when communicating by email without encryption. Only non-urgent matters shall be communicated by email, as practice staff may not read all their emails on a daily basis. Urgent matters will always be communicated by telephone. If you hare happy to receive email communications from us you will need to provide your written consent below:
