Patient Consent Agreement
For ease of reference, any defined terms in this document have the same meaning as those set out in Stagger’s Website Policies and Terms previously accepted by you. A further copy of Stagger’s Website Policies and Terms can be found here.
If you have any questions about or you would like anything in Stagger’s Website Policies and Terms explained to you, please do not proceed with completing this consent form and instead contact Stagger at firstname.lastname@example.org.
Prior to your consultation with a Doctor, you are required to acknowledge and agree with (and provide consent to, where applicable) the matters set out below.
Stagger and Doctors engaged by Stagger require your consent to collect, use and disclose your personal health information for any of those Doctors to provide you with safe and appropriate health care. That consent will be collected by Stagger and the Doctors engaged by Stagger, in your acceptance of Stagger’s Website Policies and Terms and by providing your consent and agreement to the matters below. By clicking ‘Continue’, you confirm, that you acknowledge and agree that:
- You have read, understood and accepted Stagger’s Website Policies and Terms;
- You consent to Stagger and the Doctors engaged by Stagger collecting, handling and using my personal information and personal health information for the purposes as set out in Stagger’s Website Policies and Terms and this Patient Consent Form;
- You consent to the potential forms of consultation with a Doctor as set out in Stagger’s Website Policies and Terms;
- You consent to a Doctor contacting you via the encrypted chat service on the Website or via any other means as considered appropriate and necessary by the Doctor; and
- You acknowledge and agree that the Doctor (and not Stagger) has total and full discretion and professional judgment in assessing your medical and health condition and determining any suitable course of action, and you consent to this treatment.