New patient registration

Consent to collect health information and claim Medicare rebates

I authorise Balwyn Dermatology to collect my health information. I understand it is collected for the purpose of my care, may be disclosed to health departments, legal entities or other related organisations, and that I have the right to access it.

I authorise Balwyn Dermatology to claim rebates directly from Medicare for any agreed procedure. I understand I am responsible for out-of-pocket fees, which are the fees after any rebates.