Stoma Appliance Scheme Australian Privacy Principle 5 notification and consent form
Save a copy by right-clicking on the download link and saving to your computer. Open the file and then fill in the details.
We aim to provide documents in an accessible format. If you're having problems using a document with your accessibility tools, please contact us for help.
Ostomates who need more than 4 times the maximum quantity allowed for stoma products and appliances listed in the Stoma Appliance Scheme Schedule should sign this consent form. This allows us to access personal information so that we can assess eligibility.