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​CONSENT TO RELEASE MEDICAL INFORMATION
If you wish to have consultation notes or results sent to your GP or another specialist, please download and complete our Patient Authority to Release Medical Information to a Nominated Party form via the link below.
Please ensure you scan and email the completed form to:
​
reception@leake.com.au for Drs Leake and Fitzgerald
reception@drjenniferpontre.com.au for Dr Pontré
reception@karthigasu.com.au for Dr Karthigasu
info@drpipparobertson.com.au for Dr Robertson
reception@julania.com.au for Dr Julania
or
b) Bring the completed hard copy form to your initial appointment.
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