RPPR WHSO Consent Form

Fields marked with an * are required

AUTHORISATION

I hereby give permission for my Work Colleague / Rehab & Return to Work Coordinator (RRTWC) of my present employment, or prospective employment to be present or discuss my injury / illness with Dr. David Jaa of Suite 6 Riverwalk One, 140 Robina Town Centre Drive, Robina  Qld 4226.

I understand this consent is required to assist with my return to work / rehabilitation and that all the information obtained is treated in confidence.

I also understand that I may be tested in ways which require urine and blood testing including drug screening.

Patient Consent

Employees of Dr Jaa's Medical Health and RPPR are independent health contractors.  Therapy not endorsed by Dr Jaa or Dr Jaa's Medical Health as way of written referral is considered the legal responsibility of the independent contractor.

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