Sutherland Heart and Lung Health Team Community Care Plan

Jun 28th, 2015
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Acadia University
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My GP/health professional has explained the purpose of a care plan. I give my permission to prepare a care plan and discuss my medical histroy and diagnosis with the members of a multidisciplinary team. I do/do not request specific medical of other information to be with held from other participant’s (noted in medical records). I am aware that there is a fee for the preparation of this care plan and a Medicare rebate will be payable.

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Sutherland Heart and Lung Health TeamCommunity Care PlanPatients Name: ____________________________ DOB: _______________ Patients Signature: ____________________________ Date:_____________________AUTHORITY TO PROCEED WITH CARE PLAN:My GP/health professional has explained the purpose of a care plan. I give my permission to prepare a care plan and discuss my medical histroy and diagnosis with themembers of a multidisciplinary team. I do/do not request specific medical of other information to be with held from other participants (noted in medical records). I amaware that there is

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