Working Time
Mon-Thu | 10:00 - 20:00 |
Sunday and national holidays | Closed |
As a prospective patient, it is imperative that you provide comprehensive and accurate medical information to ensure your safety and the efficacy of your medical treatment. Please read and acknowledge the following:
- Full Disclosure of Medical History:
You agree to disclose all relevant aspects of your medical history, including but not limited to, previous surgeries, chronic conditions, allergies, current medications, and any known medical conditions or illnesses.
- Accuracy and Completeness:
You confirm that all the medical information you provide is complete, accurate, and up-to-date. Any changes in your medical condition after submitting the information must be promptly communicated to us.
- Consent to Obtain Medical Records:
You consent to our medical team obtaining your medical records from your healthcare providers if necessary. This may include contacting your primary care physician, specialists, or previous healthcare facilities.
- Confidentiality and Privacy:
All medical information you provide will be treated as confidential and will be used solely for the purpose of assessing your suitability for the proposed medical treatments and ensuring your safety during your medical journey. Your information will be protected in accordance with applicable privacy laws.
- Severe Implications of Non-Disclosure:
You understand that failure to disclose accurate and complete medical information can result in severe health risks, inappropriate treatment, serious complications, or even death. In such cases, our organization and medical providers will not be held liable for any adverse outcomes that may arise due to incomplete or inaccurate disclosure of medical information.
- Legal and Financial Responsibility:
You acknowledge that any medical complications or issues arising from the non-disclosure or inaccurate disclosure of medical information may result in additional medical expenses or legal consequences, for which you will be solely responsible.
- Consultation and Clarification:
If you have any questions or need clarification regarding the information required, you agree to consult with our customer support team before proceeding with any treatments or travel arrangements.
By signing this document, you acknowledge that you have read, understood, and agreed to the terms of this Medical Information Disclosure Clause. Your signature also confirms that the information provided is truthful and accurate to the best of your knowledge.
Patient's Signature: ________________________
Date: ________________________