Информированное согласие пациента на оказание онлайн (дистанционных) медицинских услуг (консультаций)

Informed consent of the patient for online (remote) medical services (consultations)

This consent is drawn up in accordance with Article 77, Section 2, 134, Section 3 of the Code of the Republic of Kazakhstan “On the Health of the People and the Health Care System” dated 07.07.2020 No.360 - VI of the Law of the Republic of Kazakhstan

I agree to the provision of online (remote) medical services (consultations) by means of telecommunications.

I give my consent to the collection, processing, storage, reproduction and use of biometric and personal data (photo, video, and personal information) in accordance with Article 145 of the Civil Code and the Law of the Republic of Kazakhstan “On personal data and their protection”.

I am informed and confirm that I agree with the following:

1. When I get online (remote) medical services (consultations) in the absence of my previous diagnosis:

• The consulting specialist can only provide me with general background information on the medical issues that are the subject of my application and that this information cannot replace a face-to-face appointment with an attending physician during a visit to a medical organization, which may be required, and therefore the information I receive can under no circumstances be used by me for independent treatment and diagnosis;
• That in the process of providing online (remote) medical services (consultations) I will not be diagnosed with the existing disease and will not be prescribed treatment. In this case, the purpose of the service will be to collect and analyze complaints and history, to give me recommendations on the need for certain examinations, and to make a decision on the need for a face-to-face appointment.

2. When I get online (remote) medical services (consultations) if I have a previous diagnosis:

• recommendations (prescriptions) will be based on the assumption that the previous medical diagnosis of my disease is correct or substantially correct, if it is also confirmed by the data of the examinations (anamnesis, test results, medical reports), which I will provide and on which the specialist’s medical opinion will be based;

• the specialist has the right to doubt my previous medical diagnosis and to prescribe repeated or additional examinations;

• based on the results of repeated or additional examinations, the specialist may adjust or completely change the treatment prescribed to me, as well as refuse to give an opinion if the specialist is not sure of the correctness of the diagnosis made or if it is impossible to make a correct diagnosis, as a result of which I may be advised to have a face-to-face appointment with a specialist, including to decide on the appointment of surgical intervention.

3. I certify that the information about test/research results I have provided to the specialist via email or otherwise is true and correct and all information in my possession and I am responsible for it.

4. I have been warned that:

• failure to comply with the instructions (recommendations, prescriptions) of the specialist in any of the above-mentioned cases may reduce the quality of the provided online service, entail the inability to complete it on time or adversely affect my health condition;
• result of the online service cannot be guaranteed to me, including due to possible insufficiency of diagnostic information found during the remote appointment, as well as the limited capabilities of the specialist during the remote appointment compared to the face-to-face appointment, which may be recommended to me.

The medical organization, specialist of which provides remote consultations has the right to refuse to provide me with the online service.

Acceptance of the terms and conditions of this Informed Consent during the registration process shall be deemed to be a written signature of this document on my part.

Informed consent of the patient for online (remote) medical services (consultations)

Hospital Partners