Get New Client Consent And Acc Information Form - Kcpphysio Co

Filling out the NEW Client Consent And ACC Information Form online is a straightforward process that ensures you provide all necessary information to Kcpphysio Co. This guide will help you navigate each section of the form with clarity and support.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to initiate access to the form and open it in your chosen editor.
2. Begin by filling out SECTION 1 - PERSONAL INFORMATION. Provide your first name, preferred name (if applicable), last name, date of birth, and ethnicity. Ensure that all contact numbers, along with an emergency contact name and number, are included.
3. Continue completing SECTION 1 with your email address, which will be used for communication regarding exercise programs and other updates. Fill in the address and employer information if relevant, including postal codes.
4. In SECTION 2 - GENERAL HEALTH QUESTIONNAIRE, indicate any relevant health conditions. This may include pregnancy, allergies, or any disabilities. List any medications you are currently taking.
5. If applicable, fill out SECTION 3 - ACC CLAIM INFORMATION. Record the date and time of the injury, the scene/site of the injury, location, and body part affected. Provide a description detailing how the injury occurred.
6. In SECTION 4 - CONSENTS, carefully read and consent to treatment by a qualified Physiotherapist. Acknowledge your understanding regarding payment responsibilities and your consent to share information with third parties for managing your condition.
7. Review all the information filled in for accuracy. Once complete, proceed to sign and date the form. If under 16, ensure a parent or guardian signs and includes their contact number.
8. Finally, save your changes, and decide whether to download, print, or share the completed form according to your needs.

Complete your document online today to ensure a smooth onboarding process with Kcpphysio Co.