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For Australian ENT rooms

ENT patient registration and surgery consent forms

Registration at booking. Your surgery consent and fee estimate after the consult. Signed paperwork kept together on the patient record.

  • Signed on the patient’s phone
  • Your practice’s own wording
  • Australian data hosting
Start with the ENT setupSee the consent and quote

Professional access for 30 days. No card. Registration and consent stay free on every plan.

An ENT specialist and patient talking through the paperwork, with a tablet held on the patient’s lap

For your rooms: one registration link before the first visit, then your procedure consent and quote when surgery is planned. The patient can mark a question before signing. Their signed PDF stays on the record and is filed to Cliniko or PracSuite when connected.

Follow the order your rooms already use

  1. At booking

    Registration before the appointment

    Your rooms share a link or QR code. The patient enters their details on their phone, checks them, and signs your consent to treatment. Their registration arrives on the record with an email to your practice.

  2. After the consult

    Your procedure consent and fee estimate

    Choose the procedure on the patient record, adjust the quote and side for this patient, then copy the signing link into your email or text. The patient reads your wording, marks any question, and signs once for the consent and quote.

  3. Back in the rooms

    The signed record and any question

    The PDF keeps the wording and figures exactly as signed. Your rooms can open the record, download the paperwork, and see any question that needs a response.

The registration on their phone

Contact details, healthcare details and a check before sending. These are screens from the registration your patient receives.

Springfield ENT

Step 1 of 5 · About You · ~6 min left

Fields without “(optional)” are required.

1 · Your name

Title (optional)MrsFirst nameMargeLast nameSimpsonPreferred name (optional)What you like to be called

2 · About you

Date of birth19/03/1984
Continue
Springfield ENT

Step 4 of 5 · Health Care Information · ~3 min left

1 · Your Medicare card

The 10 digits across the middle of your Medicare card.

Medicare number (optional)2951 64830 1IRN1

The IRN is the number next to your name on the card (1-9)

Expiry date (optional)08/2029

2 · Health fund & DVA

Only if you have one. This helps your clinic with claims.

Do you have private health insurance?

YesNoFund (optional)Springfield MutualMember # (optional)40318822ID # (optional)02

3 · Your GP

So your clinic can coordinate care if you want them to.

GP name (optional)Dr Marvin Monroe
BackContinue
Springfield ENT

Step 5 of 5 · Check before you send · ~1 min left

Check before you send

Everything's here.

About YouEdit this stepCompleteMarge Simpson, born 19 March 1984.How to Reach YouEdit this stepCompleteWe'll reach you at marge.simpson@example.com or 0491 570 006.Emergency ContactEdit this stepCompleteHomer Simpson (Husband).Health Care InformationEdit this stepCompleteMedicare ending 01, Springfield Mutual member, GP Dr Marvin Monroe.
BackSend to your clinic
1Five steps, and the time left. About You, How to Reach You, Emergency Contact and Health Care Information, then one screen to check. Your own questions, up to ten, come after these, up to seven to a page.
2Comfort. The patient can make the text bigger, raise the contrast, switch to an easier-to-read typeface, add spacing or turn movement down.
3Medicare, health fund and GP. On from the start, each with a line on why it's asked. Switch any of them off when you edit your registration.
4Check before you send. Every step read back on one screen, with Edit this step beside each. It arrives on the patient's record, and you get an email.

Kept as the patient signed it

The signed PDF keeps the exact wording, fee estimate and signing time. Your rooms can download it from the patient record. With a supported practice-system connection, the signed paperwork is filed there too.

Consent and quote

Springfield ENT

Patient
Marge Simpson
Procedure
Myringotomy and insertion of ventilation tubes, both sides
Everyday name
Small tubes in the eardrums (grommets)
Surgeon
Dr Julius Hibbert
Signed by
Marge Simpson, 21 Aug 2026, 7:15 pm

Quote (an estimate, valid until 20 November 2026)

Surgeon’s fee$2,400.00Assistant surgeon’s fee$400.00Total fee$2,800.00Estimated rebate, Medicare and your health fund combined-$1,150.00Out-of-pocket$1,650.00

Not included: Hospital and anaesthetist fees, billed separately.

What Dr Julius Hibbert recommends

Small tubes in the eardrums (grommets) (Myringotomy and insertion of ventilation tubes, both sides)

Explained by Dr Julius Hibbert.

Risks of any operation

Risk one. The practice’s own wording for this risk of any operation.

Written by Springfield ENT.

Risks of this procedure

Risk one. The practice’s own wording for this risk.

Risk two. The practice’s own wording for this risk.

Written by Springfield ENT.

Marge Simpson marked a question: Risk one.

Blood testing

The practice’s own wording about blood testing.

Answer: Yes

Consent

I, Marge Simpson, consent to having the procedure named above. I have read the risks, the quote and the other consent.

Marge Simpson

Marge Simpson, 21 Aug 2026, 7:15 pm. Typed signature.

Record 3f9c2a7b1d04Page 2 of 2
1Who, what and when. The patient, the procedure and side, its everyday name, who explained it, and who signed and when.
2The quote as signed. Each fee, the total, the estimated rebate and the out-of-pocket.
3Every risk, as your practice wrote it. With any question the patient marked.
4Other consents and the answer. Yes or no, as the patient answered.
5The exact sentence they signed. Word for word, with their signature and the time.
6A record reference on every page. With page numbers. What was signed can't be changed afterwards, even when you edit your wording.

Planned: payment receipt collection

Keep the transfer receipt with the paperwork

Your rooms will be able to create a separate receipt link with a requested fee and pay-by date. The patient can send their bank-transfer proof when they have it, without holding up registration or consent. Phone payment can stay part of your existing process.

After the receipt is checked and filed, a minimal email will notify your clinic. The receipt stays on the ClientForms patient record, with earlier versions kept when a patient replaces it. Your rooms will check the transfer before confirming payment.

Illustrative example only. Fictional clinic and fee; the controls below are a preview.

1. The patient can send it later

Send your payment receipt

Springfield ENT has requested a fee of $428.35, due 10 October 2026.

If you paid by bank transfer, attach the receipt from your bank. Use the payment instructions your clinic gave you.

You can do this later. It does not hold up your registration or consent.

Your receipt stays with the practice’s payment records for at least 7 years. This page cannot remove it. Contact Springfield ENT about its use.

PDF, JPG or PNG · up to 10 MB. Include only the receipt for this payment.

2. After filing, the clinic is notified

Payment receipt submitted

A payment receipt has been submitted to your practice.

Open the patient record to check it against the transfer.

Open the patient record

Receipt submission does not confirm cleared funds.

The email goes to your configured practice inbox, or the team member who created the request. Opening the record requires sign-in. The receipt is kept on the record if email cannot be confirmed.

3. The rooms check the transfer

Payment receipts

Proof of a transfer stays with the patient record. Check the transfer before confirming payment.

$428.35 · due 10 Oct 2026

Receipt received, awaiting review

Fee entered by the rooms for this request.

  • Latest receipt · PDF · 24 KB · 30 Sept 2026

    Download receipt

    Clinic notification: accepted by email provider.

Request history
  • submitted · 30 Sept 2026

Receipt received stays separate from transfer confirmed. The email status records provider acceptance; it does not prove arrival in an inbox.

This workflow is being verified for Australian ENT practices. Receipt collection is not yet available in the production ENT setup.

Questions from ENT rooms

Can we use our own ENT consent wording?

Yes. Your practice writes the procedure, indications, risks and declarations. The examples show a structure for your wording. They do not provide clinical risk advice.

Can the patient read a fee estimate before signing?

Yes. Your quote shows the fee lines, total, estimated rebate and expected out-of-pocket cost. The patient reads your quote and consent, can mark a question, and signs once for both. Rebates remain estimates.

Do patients need an account?

No. Registration and consent open from a link on the patient’s phone. Your rooms can share the registration link or QR code at booking, and copy the procedure signing link into your existing email or text after the consult.

Where does the signed paperwork go?

The signed PDF stays on the patient record with the wording and figures shown at signing. It is filed to Cliniko or PracSuite when connected. Your rooms can also download it from the record.

Can patients upload a bank-transfer receipt?

Payment receipt collection is planned. The proposed follow-up lets a patient submit proof without holding up registration or signing. Your rooms would receive a notification and check the transfer separately. A receipt alone does not confirm cleared funds.

What does it cost to use registration and consent?

Registration and consent forms are free on every plan. New practices get Professional access for 30 days without a card. See pricing for branding and other Professional features.

Put your rooms’ paperwork on the patient’s phone

Start with the ENT setup, then make the wording your own.

Start with the ENT setup

See pricing