KERITH ROBY SPEECH-LANGUAGE PATHOLOGY

ABN: 46 722 844 642

Consent to Collect Information
Kerith Roby Speech-Language Pathology needs to collect information about you/your child for the primary purpose of providing a quality service to you/your child. In order to thoroughly assess, diagnose and possibly provide therapy, we need to collect some personal information from you (about your child). If you do not provide this information; we may be unable to treat you/your child. This information will also be used for:

The administrative purpose of running the practice;
Use within the practice if passing your case to another speech pathologist within the practice for your/your child’s ongoing management;
Disclosure of information to your/your child’s doctors, other health professionals or to teachers to facilitate communication and best possible care for you/your child

We do not disclose your personal information to overseas recipients.
Kerith Roby Speech-Language Pathology has a Privacy Policy that is available on request. This policy provides guidelines on the collection, use, disclosure and security of your/your child’s information. The Privacy Policy contains information on how you may request access to, and correction of, your/your child’s personal information and how you may complain about a breach of your/your child’s privacy and how we will deal with such a complaint. A summary of the Privacy Policy is contained in the Collection Statement overleaf.

I have read the above information and understand the reasons for collecting the information and the ways in which the information may be used. I understand that it is my choice as to what information I provide and that withholding or falsifying information might act against the best interests of my/my child’s assessment and therapy progress. I am aware that I can access my/my child’s personal and treatment information on request and if necessary, correct information that I believe to be inaccurate. I understand that if, in exceptional circumstances, access is denied for legitimate purposes, that the reasons for this and possible remedies will be made available to me. I understand that the Practice must obtain additional consent if the information collected is to be used in any ways other than that outlined above.

https://kerithrobyspeech.com.au/policies

Cancellation policy

https://kerithrobyspeech.com.au/policies

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