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Patient Consent Form

To receive my chemotherapy, immunotherapy and/or supportive care at home.

  • I understand that when it is clinically needed, I will attend a health care facility
  • examples include if I have a high temperature, need blood products or need to be reviewed by a doctor.

For View Health / chemo@home to access relevant clinical information related to my care from other health care services/facilities and to share relevant clinical information related to my care with my treating medical team and other health professionals as necessary to ensure I receive appropriate care.

Please note this consent form relates to having your treatment at home. Consent over your choice of treatment occurs during your consultation with your doctor.