We are committed to providing our patients with the best care, to do this, it is essential that your health record contains complete and accurate information. Please assist us by completing your new patient record form

Next of Kin DETAILS



Valewood Clinic collects information from you for the primary purpose of providing quality health care. We require you to provide us with your personal details and a full medical history so that we may properly access, diagnose, treat and be proactive in your health care needs. This means that we will use this information for administrative purposes, billing, disclosure to others involved in your health care including specialists and other treating doctors outside the practice and disclosure to other doctors in the practice including locums to assist in your medical care.

This practice may occasionally be involved in research and quality assurance activities to improve individual and community health care and practice management. All information is de-identified. If you wish to opt out of research undertaken by the clinic please inform your doctor. We wish to assure you that at all times your health information is treated with utmost confidentiality.

This form provides information about the risks of electronic communication with Valewood.

Communication by electronic means has a number of risks which include, but are not limited to the following :

  • Electronic communication can be circulated, forwarded and stored in paper and in electronic forms
  • Backup copies of email may exist even after the sender or the recipient has deleted his/her copy
  • Electronic communication can be received by unintended recipients
  • Email can be intercepted, altered, forwarded or used without authorization or detection
  • Email can be used to introduce viruses into computer systems

You should not communicate with Valewood Clinic via electronic communication if any of the above risks concern you.