Patient Consent Agreement

INFORMED CONSENT FOR ONLINE DOCTOR CONSULTATION

 I the undersigned hereby agree to participate in an online consultation carried out by Cabinet Virtual medical Lisnic. I understand that if I supply incorrect information it could lead to inappropriate advice being given to me or the wrong medicine being prescribed, which could be harmful to my health.

-I confirm that I have had a recent appointment with my own doctor.

- I am agreeing to this online consultation of my own volition and I am above 18 years old

- I agree to share with the Medical practitioner any health records,images or videos related to my ailment or Health condition.

-I require the particular medicines which I have ordered solely for my personal use and I agree not to give, sell or pass them to any other person.

-I agree to carefully read all product packaging and labels prior to use.

-I understand that I must consult my doctor before taking any new product.

-I confirm that I have answered all questions truthfully and to the best of my knowledge.

-I have been fully informed and understand the risks, benefits and any possible side effects of the medicines that I request.

-Should any complications or side effects develop I agree to immediately contact a doctor for advice or assistance.

The online consultation is confidential; the results will only be released to other medical professionals or other parties with my written consent. All data is confidential and will not be released within legal limit. Participation in online consultation is completely voluntary.