Participant Release of Information Consent pursuant to Federal Privacy Act 1988 (AU) or Privacy Act 1993 (NZ)
I confirm that my participation in this Health Check is voluntary.
I acknowledge that any personally identifiable health information obtained in conjunction with this health check will be protected and will only be used in accordance with this agreement and applicable laws pertaining to the use of personal health information.
I understand that any health information obtained, may be used to compile a deidentified aggregate report for my company/employer. While my employer may be notified of my participation, my individually identifiable health information will not be shared with my employer.
I consent to the collection of blood pressure, body composition data (including waist circumference, height, weight, BMI) and a blood sample for the purpose of measuring my cholesterol and glucose levels.
I understand that the data derived from the check is considered to be preliminary and for screening assessments only. The data collected does not constitute a diagnosis. The responsibility for initiating a follow-up examination to confirm the results of this screening and obtain professional medical assistance is mine alone and not that of my employer or any organisation associated with these health checks.
Additionally, as frontline health professionals we are following government advice at the moment and asking each patient about recent travel and flu symptoms. Please confirm that
- I have not travelled to, including transit through, any international countries as per the Australian Government’s mandate in the last 14 days.
- I have not been in contact with anyone with a confirmed case of coronavirus within the last 14 days.
- I do not have any flu symptoms such as fever, cough, sore throat, fatigue or shortness of breath.
I hereby give Bodycare Health & Wellbeing Pty Ltd consent to release the de-identified results of my health questionnaire as part of an aggregate result to the relevant department of my employer.