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Nicotine Cessation Support - $19 AUD
1
Your Details
Full Name *
Email Address *
Mobile Number *
Date of Birth *
Address *
2
Choose Your Appointment
Appointment Date *
Select Time Block * (AEDT)
Early Morning 0600-0900 (6am to 9am)
Morning 0900-1200 (9am to Midday)
Afternoon 1200-1500 (Midday to 3pm)
Late Afternoon 1500-1700 (3pm to 5pm)
Evening 1700-2000 (5pm to 8pm)
Booking Notes (Optional)
3
Terms & Conditions
1. Nature of the Service
Easy Quit provides doctor-led telehealth consultations for nicotine cessation.
This service is designed to support the reduction or cessation of nicotine use.
It is not an emergency service and does not replace comprehensive care from your regular GP.
2. Payment and Booking
• Full payment is required at the time of booking
• Booking secures a consultation time block, not a guaranteed call time
• Calls may occur at any point within the selected time window
• Failure to answer the call may result in the consultation being deemed attended
Refunds and cancellations are managed in accordance with the Easy Quit cancellation policy.
3. Intake Form Requirement
• Completion of the intake form is mandatory
• Failure to complete the intake form prior to the consultation may result in cancellation
• Incomplete or inaccurate information may affect clinical decision-making
You confirm that the information you provide is accurate and complete to the best of your knowledge.
4. Clinical Assessment and Prescribing
• All treatment decisions are made by the consulting doctor
• Prescribing is not guaranteed
• The doctor may determine that treatment is not clinically appropriate
If treatment is not appropriate, alternative advice or referral may be provided where suitable as well as a refund issued.
5. Identity, Monitoring, and Regulatory Checks
By booking, you consent to the doctor undertaking appropriate checks, including but not limited to:
• Review of your medical history
• Accessing My Health Record where available
• Conducting SafeScript or equivalent real-time prescription monitoring checks
These checks are required to meet legal, clinical, and safety obligations.
6. Patient Portal and Medication Supply
If treatment is approved:
• You will receive access to a secure patient portal
• The portal allows you to view your treatment plan
• Medication orders and delivery status are managed through the portal
Medication delivery times are estimates only and may vary based on location, availability, and external providers.
7. Local Dispensing and eScripts
At any time, you may request:
• An electronic prescription (eScript)
• Dispensing through a pharmacy of your choice, where clinically appropriate
Requests for local dispensing do not guarantee availability or pricing at external pharmacies.
8. Follow-Up and Ongoing Care
• Ongoing treatment requires clinical review at least every 6 months
• Failure to attend required reviews may result in treatment cessation
• The doctor may recommend earlier review if clinically indicated
9. Risks and Limitations
You acknowledge that:
• Nicotine cessation treatments may cause side effects
• Outcomes cannot be guaranteed
• Treatment suitability may change over time
You agree to seek urgent medical care if you experience severe or concerning symptoms.
10. Communication
• Communication is primarily via phone/email and secure portal
• SMS and email messages are administrative and not medical advice
• Easy Quit does not provide after-hours emergency support
11. Consent
By booking and proceeding with payment, you confirm that:
• You have read and understood these Terms and Conditions
• You consent to telehealth consultation which may include AI transcription services.
• You consent to required regulatory and safety checks
• You understand the limitations of this service
I have read and agree to the
Terms & Conditions
and consent to receiving telehealth services from Easy Quit. I understand that a doctor will call me during my selected time block. *
Consultation Fee
Nicotine Cessation - Telehealth (~10 min)
$19.00
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