Consent to Release Medical Information
If you wish to have consultation notes or results sent to your GP or another specialist, please complete our Patient Authority to Release Medical Information to a Nominated Party form.
If you would prefer to complete a hard copy, you are able to download the form at the end of this page. If this is your preference, please ensure you scan and email the completed form to reception@leake.com.au for Dr Leake and Dr Pontré, or reception@karthigasu.com.au for Dr Karthigasu.
Consent to Release Medical Information
Should you prefer to complete a hard copy of this form, please download via the link below and email a completed copy to our Rooms.