Looking for a Australian Legal Forms And Templates? Download it for free!

Notes: Form 12B – Record of refusal of patient’s request to access document

When to use this form:

A person who is or was provided with treatment or care by a mental health service is entitled to

inspect, and to be given a copy of, any relevant document relating to the person that is in the

possession or control of —



the person in charge of the mental health service; or



a staff member of the mental health service (s248).

If a request to access a relevant document is refused, a record of the refusal must be made on

this form.

Refusal of request to access a document:

A request must be refused:



if a psychiatrist reasonably believes that disclosure of the information in the document

to the person —

o poses a significant risk to the health or safety of the person or to the safety of

another person; or

o poses a significant risk of serious harm to the person or to another person;



if disclosure of the information in the document to the person would reveal —

o personal information about an individual who is not the person; or

o information of a confidential nature that was obtained in confidence.

(unless the personal information is about an individual who consents to the disclosure of

the information).



if the person is or was a mentally impaired accused required under the Criminal Law

(Mentally Impaired Accused) Act to be detained at an authorised hospital; and the

relevant document came into existence under, or for the purposes of, the Prisons Act

1981 (s249).

Steps person can take if request refused:



If a person has been refused access to a relevant document the person may nominate

a medical practitioner or a legal practitioner or both to inspect, and be given a copy of

the relevant document (s250(2)).



The nominated practitioner is entitled to inspect and be given a copy of the relevant

document as soon as practicable (s250(3)).



The person who inspects, or is given a copy of a relevant document must not disclose

any information in the document to the person who has been refused access. The

penalty for doing so is a fine of $5,000 (s251).

Notes

Checklist of Mental Health Act 2014 requirements related to

this form :

 Give the person a copy of this form as soon as practicable.

 File this form on the person’s medical record.

March 2016

Form 12b - Record Of Refusal Of Patient'S Request To Access Document - Western Australia Page 2

Related Articles

Related forms

Related Categories