I agree to the following:
Please tick: Any pre-existing medical or other condition that may affect or risk other persons or myself
Consent To Medical Attention
Privacy Statement – Privacy Act 1998
By completing this form you are supplying the Provider with personal information about yourself. This information is needed to ensure your safety during your time with us. The Provider is required to collect this information by our insurance company and by the department of Workplace Health and Safety. This information you provide will not be supplied to any other organisation or used for any other purpose than that which is stated above.
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