Online Referral

Issues to address:

By submitting filling out this request form and supplying it to LRHG, you indicate that you have read LRHG's privacy collection notice and acknowledge that your personal information will be collected and handled in accordance with that notice.

I confirm that I have informed the patient and obtained their consent regarding the following:

1. The patient's personal information, including health information, will be shared with Life Ready Mobile for the purpose of providing home rehabilitation services.

2. Life Ready Mobile will reach out to the patient to discuss the services. If they are unable to reach the patient after three attempts, they will contact the next of kin.

3. Life Ready Mobile may be required to disclose the patient's personal information to their health fund or its authorised agencies to confirm their eligibility for the services, receive confirmation of service, and facilitate their participation in the program. All parties involved are bound by strict obligations of confidentiality and privacy.

By submitting filling out this request form and supplying it to LRHG, you indicate that you have read LRHG's privacy collection notice and acknowledge that your personal information will be collected and handled in accordance with that notice.