(03) 9716 0333
Shop 1, 81 Church Street Whittlesea, VIC, 3757

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(03) 9716 0333


Shop 1, 81 Church Street Whittlesea, VIC, 3757

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Patient Information

New Medical History & Consent Form


Child Dental Benefits Schedule

Your child might be eligible for a $1026 dental voucher from Medicare.


What is the Child Dental Benefits Schedule?

The Child Dental Benefits Schedule is a dental benefits program for eligible children aged 2-17 years that provides up to $1000 in benefits to the child for basic dental services.


Which children are eligible for dental services?

A child’s eligibility for the Child Dental Benefits Schedule is assessed by the Department of Human Services.  A child is eligible if they are aged between 2-17 years at any point in the calendar year and receive a relevant Australian government payment, such as Family Tax Benefit A, at any point in that calendar year.


We fully Bulk Bill our patients who qualify for the Child Dental Benefits Schedule.


Your Health Information

In accordance with the Victorian Health Records Act 2001 and Federal Privacy Act 1988

Our Practice Respect your right for privacy. We realise that is it important that you understand the purpose for which we collect the details about your health, as well as how this information is used to our practice and to whom this information might be disclosed. 


The policy of our practice is to follow these procedures:

  1. The information collected will be used for the purpose of providing treatment to you. 

Personal information such as your name, address and health insurance details will be used for the purpose of addressing accounts to you, as well as processing payments, and writing to you about our services and any issues affecting your treatment.

  1. We may disclose your health information to other health care professionals, or require it from them, in our judgment, that is necessary in the context of your treatment. In that event, disclosure of your personal details will be minimised wherever possible.
  2. We may also use parts of your health information for research purposes, in study groups or at seminars as this may provide benefit to other patients. Should that happen, your personal identity will not be disclosed without your consent to do so.
  3. Your medical history, treatment records, x-rays and any other material relevant to your treatment will be kept here. You may inspect or request copies of our records of your treatment at any time, or seek an explanation from the dentist. Statutory fees will apply in relation to the types of access you seek. If you request an explanation of our records or a written summery, our usual fees apply to these services. 
  4. If any of the information we have about you is inaccurate, you may ask us to alter our records accordingly.

You can otherwise rest assured that your health information will be treated with the utmost confidentiality. Disclosure will not be made to any person not involved in either your treatment or the administration of this practice, without your prior written consent. If you have any queries or concerns about our handling of your health information, please do not hesitate to raise these concerns with our practice.