ABF Practitioner Read and Understood "*" indicates required fields Clinical Assurance and Protocol Acknowledgment This form is part of our quality assurance process to ensure that all medical assessments are thoroughly reviewed and understood by the Registered Practitioner responsible for their evaluation. By completing this form, you acknowledge that you have received, reviewed, and understood all relevant medical documentation provided, including any associated protocols, guidelines, and standards. This Practitioner Read and Understood Statement is for services delivered for candidates of the Australian Border Force (ABF). Clinic DetailsClinic Name*Clinic Address*State*Clinic Contact Details*Clinic Email* The following tables detail the service delivery type, work instructions and standards provided to the Authorised Partner Clinic. It is expected that all Medical Practitioners and/or Exercise Physiologists who conduct Medical and/or Fitness assessments for ABF have read and understood the requirements related to the assessment. Type of Assessments Please ensure that you tick all the boxes if relevant.Types of Assessments 1. BFO Basic Medical Assessment Basic Medical Assessment* BFO Basic Medical Assessment Requirements BFO Basic Medical Assessment BFO Examinee Medical History Questionnaire BFO Basic Medical Fit Slip ACH Consent and Declaration Form Type of Assessments 2 2. BFO Basic Fitness Assessment Basic Fitness Assessment* BFO Basic Fitness Protocol BFO Basic Fitness Assessment BFO Basic Fitness Fit Slip ACH Consent and Declaration Form Type of Assessment 3 3. BFO Use of Force including Fitness Use of Force including Fitness* BFO Use of Force Medical Requirements BFO Use of Force Medical Assessment BFO Use of Force Medical Assessment over 50 BFO Examinee Medical History Questionnaire BFO Use of Force Capability Medical Fit Slip BFO Use of Force Functional Fitness Assessment Protocol BFO Use of Force Fitness Fit Slip BFO Medical + Fitness Assessment Work Instructions ACH Consent and Declaration Form Type of Assessment 4 4. CEF Container Examination Facility Assessment CEF Container Examination Facility Assessment* BFO Examinee Medical History Questionnaire Fitness to Wear Respirator CEF Medical Assessment Requirements CEF Medical Assessment Form CEF Medical Fit Slip BFO Basic Fitness Slip ACH Consent and Declaration Form Statement Declaration By ticking the box below, I confirm that I have: Received the medical assessment documents, including all relevant reports, standards, and associated materials. Read the content of the documents thoroughly. Understood the information provided, including any relevant guidelines, protocols, or instructions that apply to the medical assessments. I acknowledge my responsibility to ensure that I am fully informed and compliant with the materials provided.Above* Yes No Other Other Registered Practitioner Details I confirm that I have read and understood the above statement.Prefix*(Select one of the below)Dr.Mr.Miss.Mrs.Prefer not to say.Registered Practitioner Name*APHRA Registration number*Email address*Phone number*Date* DD slash MM slash YYYY If required, please submit your CV .Max. file size: 2 MB.*This statement is subject to Aspen Medical Privacy Policy and as such may be shared with the client if requested.
