Pursuant to the Privacy Act 2020, the following is brought to your attention: a) This form collects personal information about you. The information collectedassists us to manage our contact with you. b) The information is primarily for the use of London Zonal hospital's Hospital. However where required, information will be passed to the Ministry of Health and other government agencies as required by law. c) The information is collected and held securely by London Zonal hospital's Hospital. d) You have rights to access to and correction of this information, subject to the Provisions of the Privacy Act 2020 and the Health Information Privacy Code 1994. Should you wish to exercise these rights, please contact the Clinical Records Department London Zonal hospital's Hospital, Private Bag 4737, London
By ticking the following box, you are confirming the above information is correct and you have read and understand the privacy statement. This action replaces your physical signature according to the Electronic Transactions Act 2002, Section 22
