Telehealth / Physiotherapy Consultation
Thank you for your interest in our services at Pinnacle Workplace Consultants. Completing the form below will help our Physiotherapists provide you and your workplace supervisor/manager with relevant support and guidance, to assist you in managing your symptoms and/or injury.
Consent to Participate
Prior to participating in the telehealth consultation can you please read and accept the Consent (read here) by completing the form below. I understand that I may agree or refuse any service or part of a service at any time. I can agree or refuse in writing or verbally.
Authority to Release/Obtain Information
I authorise Pinnacle Workplace Consultants Pty Ltd to release/obtain information relating to my assessment (including any photographs taken) to/from my employer, Doctor, treating therapists, rehabilitation coordinator and claims manager, effective for 1 year from the date provided below. I accept that this information is relevant to my wellbeing/symptoms/injury and is necessary to ensure that I receive appropriate management such that my risk of symptom aggravation is minimised and/or my wellbeing enhanced. I acknowledge that this information (including any photographs taken) may be included in any written reports.
If you have any questions or require additional support please don’t hesitate to contact us on 08 8271 6544 or email@example.com