Registry Forms and Patient Information 

Patient Information Statement 

All patients admitted to a participating hospital for CSF shunt surgery will be sent a patient information sheet from the Registry or given this information in hospital.  This sheet explains what the Registry is about and how data is collected. 

Download a sample Patient Information Statement here

Brochure

This brochure gives an overview of the aims and objectives of the Shunt Registry
If you are in New Zealand - click here 
If you are in Australia - click here 

Data Collection Form

This form shows what data is collected for entry into the Registry.

Download a sample Data Collection Form here

Opt-out

This form allows you to remove some or all of your information from the Registry.

There are two opt-out forms 
If you are the person who has had the surgery and would like to opt-out out - click here 
If you are a parent/guardian opting out on behalf of someone else - click here 

ACT Information Privacy Act 2014             Health Records (Privacy and Access) Act 1997      

VIC Privacy and Data Protection Act 2014
  NSW  Health Records & Information Privacy Act 2002 No 71 

TAS Personal Information Protection Act 2014
  QLD   Information Privacy Act 2009 

NT Northern Territory Information Act 2003 NT

SA Code of Fair Information Practice  Health Care Act 2008 
  NZ    New Zealand Privacy Act 1993    Health Information Privacy Code 1994