1. I consent to registering for a CleverSleep Medicines Therapy Assessment and
confirm that the benefits of the service have been explained to me.
2. I understand that sections of my health records may be shared with other health
professionals involved in my care.
3. I understand that the pharmacist may refer me to another health professional if
needed and that the referral will include information about my health.
4. I give permission for these individuals to have access to my health records.
5. I understand that the pharmacist may provide a summarised report of outcomes to
Health Authorities for statistical analysis, but any reports will not contain
information that enables my identification.
6. I understand I have the right to exit this service at any time and that doing so will
not affect the quality of care given to me.
7. I understand that the collection, use and storage of this information will at all times
comply with the Privacy Act 2020 and The Health Information Privacy Code 2020
8. I have read and I understand the
Health Information Privacy Statement
