Follow the steps to successfully complete the application form

1. Click the ‘Get Form’ button to obtain the form and open it in your online document editor.
2. Begin by filling out the ‘Details of Patient’ section. Provide the title, family name, given names, and any previous names if applicable. Make sure to include the date of birth in the specified format.
3. Next, fill out the residential address, including postal details, and provide both home and mobile telephone numbers.
4. If the patient is not the applicant, complete the ‘Details of Third Party Applicant’ section by providing their title, family name, given names, previous name (if applicable), date of birth, and contact details.
5. Indicate the relationship to the applicant clearly and attach documentation if you are the parent or legal guardian, such as a family court or parenting order.
6. In the ‘Consent’ section, ensure the appropriate individual authorizes the release of health information. The patient’s signature and the applicant’s signature, along with dates, are required.
7. For ‘Details of Request’, specify the date(s) or period of attendance for which health information is required, along with any specific details about documents or information you want to receive.
8. In the ‘Fees, Charges and Payment’ section, indicate whether you wish to view the documents, require copies, or need to discuss patient information. Select the appropriate options regarding payment.
9. Proceed to the ‘Identification’ section and tick off the acceptable forms of ID that you have verified. Make sure to include two forms of ID as required.
10. Finally, review all the provided information for accuracy, save any changes, print, or download the completed application, and prepare to submit it.

Complete your Nolan House Albury application online today to ensure timely processing.