General Practitioner Details (If not referring doctor)
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Cato Cardiology collects and holds personal health information about you so that we can properly assess, diagnose and treat. It is sometimes necessary to disclose information about you to other health care providers. At times it is also necessary for us to obtain information about you from other medical practitioners (or the like) in the form of previous correspondence and/or test results in relation to your health. We require your consent for this. Please ask us if you wish to discuss this further. By signing this form I also agree to pay all costs associated with my consultation and understand that failure to do so may result in my invoice being sent to a debt collection agency for recovery and extra fees will be incurred and paid for by me.