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.

Support/questions 

If you have any questions or require additional support please don’t hesitate to contact us on 08 8271 6544 or wehrc@pinnaclewc.com.au

Privacy

Pinnacle is committed to protecting your privacy. For a copy of our Privacy Policy please visit our website at www.pinnaclewc.com.au or call (08) 8271 6544

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