Patient Consent & Services Agreement

 

You must review and accept this agreement before submitting your intake form.

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1. Purpose of This Agreement

This agreement explains how Cannalink Clinic delivers care, how your information is handled, and what you are consenting to when you become a patient of a telehealth prescribing clinic.

By submitting your intake form, you confirm that you understand the nature of our service, the limits of telehealth, the risks associated with cannabis medications, and your responsibilities as a patient.

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2. Consent to Telehealth Services

Cannalink Clinic provides medical care exclusively through telephone-based telehealth consultations. By proceeding, you acknowledge that:

• Your consultation will occur by phone, without physical examination.

• You must provide complete and accurate information about your medical history, symptoms and current medications.

• The doctor may request additional records (e.g., a health summary) before prescribing.

• The doctor may determine that telehealth is not appropriate for your situation.

• You may be referred to another service when clinically required.

• If you require urgent care, you must call 000 or attend your nearest emergency department.

You also agree to:

• Attend your appointment in a private, safe, distraction-free environment.

• Be sober and unimpaired during your consultation.

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3. Consent to Collection, Use, and Storage of Personal Information

To provide medical care, the clinic must collect and store personal and health information. You consent to the clinic collecting, using, storing, and managing your information in:

• Helix – your electronic medical record

• Jotform – your intake submission

• SharePoint – secure, restricted-access document storage

• Microsoft 365 – e-mail communication

• eScript systems, including the Active Script List (ASL)

Your information will only be used for:

• medical assessment, diagnosis, and treatment

• scheduling, administration, and communication

• issuing prescriptions

• regulatory, legal, or clinical compliance requirements

The clinic does not sell, release, or disclose your information to third parties unless:

• you authorise it

• it is required to provide your care

• it is required by law

You may request access to your health information at any time.

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4. Consent to Electronic Communication

You consent to receiving communication via:

• Phone and SMS

• Email

• Secure password-protected documents

• Electronic prescriptions (eScripts)

You understand that:

• Electronic communication carries minimal inherent privacy risks.

• You must keep your contact details up to date.

• Scripts are generated automatically at the end of your consultation.

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5. Consent to the Active Script List (ASL)

You consent to:

• Your eScripts being added to your Active Script List, where applicable.

• Pharmacies accessing your ASL once they verify your identity.

You understand that:

• The clinic does not control how your ASL is managed.

• You may opt out of ASL at any time through a pharmacy.

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6. Consent for Cannabis Medicines

You acknowledge and understand that:

1. Cannabis medications may cause impairment, including intoxication, drowsiness, reduced alertness, or slowed reaction time.

2. You must not drive or operate machinery while impaired.

3. THC may remain detectable in your system for an extended period.

4. Product availability and pricing vary between pharmacies and may change without notice.

5. Doctors prescribe based on clinical judgment; not patient preference or request.

6. Treatment is not guaranteed; some patients may not be clinically eligible.

7. You must follow dosing instructions exactly as provided.

8. You must store medication safely and keep it out of reach of others.

9. You must attend follow-up appointments for repeats or continuation of treatment.

10. You must seek urgent care if you experience concerning side effects.

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7. Payment and Appointment Terms

You understand and agree that:

• Payment must be made before your initial appointment can be scheduled.

• There are no Medicare or private health rebates available.

• Follow-up appointments incur a separate fixed fee.

• Payments are made through secure online processing.

• Failure to pay may result in cancellation or delay of service.

Refunds are handled according to the clinic’s Refunds & Payments Policy.

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8. Communication and Role Boundaries

You understand that:

• Administrative staff cannot provide clinical advice, comment on treatment, or discuss medication suitability.

• Only prescribers can answer clinical questions or make prescribing decisions.

• Admin staff may assist with:

  • scheduling

  • technical support

  • payment enquiries

  • non-clinical information

• The clinic may discontinue service if behaviour is abusive, threatening, or inappropriate.

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9. Withdrawal of Consent

You may withdraw consent for telehealth, communication, or treatment at any time by informing the clinic.

You understand that:

• Withdrawal of consent may prevent the clinic from continuing your care.

• Your withdrawal will be documented in your medical record.

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10. Acknowledgement and Acceptance

By submitting your intake form, you confirm that:

• You have read and understood this Consent & Service Agreement.

• You consent to receiving telehealth services.

• You consent to the collection, use, and secure storage of your personal information.

• You understand the risks and responsibilities associated with cannabis medicine.

• You understand the clinic’s administrative, communication, and payment processes.

• You accept the limitations of telehealth and the role of prescribers.

• You agree to follow treatment instructions and attend follow-up appointments when required.

• You understand that prescribing decisions are made solely at the doctor’s discretion.