REMOTE HEALTH SERVICE CONSENT FORM

 

I have been informed about the following issues regarding the health services provided remotely by One Dose Health Technologies, which provides health services, and all health professionals it works with.

Information and Consent about Telehealth Service

  • This service is not suitable for medical emergencies. If you experience an emergency, you should call 112 to request the service or go to the nearest emergency room.
  • This service includes health counseling and health follow-up provided using electronic communication tools as part of the Distance Health Service.
  • The online service is not a substitute for face-to-face health services. This service is provided by One Dose Health Technologies via telephone, video conference or text messaging (chat). In remote consultations, some of the methods your doctor uses during a physical examination (such as touch, smell) will not be possible. However, healthcare professionals will try to help you in the best way possible within the possibilities of this service.
  • Remote health care should not interfere with your current treatment. In other words, it is important that you follow your doctor’s recommendations regarding your ongoing treatments.
  • You are obliged to provide accurate and complete information to the healthcare professional about your current health condition and ongoing treatments. The healthcare professional will make a final decision based on your current treatment and the proposed new treatment and is responsible for informing you and giving you the necessary instructions. We remind you that you are also obliged to follow the instructions given.
  • Healthcare professionals will provide services based on your medical information. Healthcare professionals cannot be held responsible for any advice given or decisions made as a result of incorrect or incomplete information provided by you or your legal representative.
  • The cost of the telehealth service may be covered by your health insurance, if you have one. Otherwise, you will have to pay for this service.
  • Camera and/or microphone access must be authorized in order for an online conversation to take place between the parties. If audio and/or video access is not allowed, it is accepted that the online interview may not start, or if it has started, it may not be continued.
  • You are receiving this service through an online platform accredited by the Ministry of Health and designed to protect data privacy. Personal health data is protected in accordance with the Turkish Personal Data Protection Law (KVKK).
  • It is forbidden to record audio or video recordings of remote health service provision without the express consent of the parties. Apart from this, data related to the health service received can be transferred to the Ministry of Health information system in accordance with the rules on the protection of personal data and can only be shared in line with legal obligations.
  • Remote health care may have some risks. These risks are listed below but are not limited to these.
    • Technical problems (e.g. telephone/video conference disconnection).
    • Data breach despite high security standards.
  • If any of these risks are encountered, the service may need to be terminated. If this service cannot be accessed for technical reasons, services should be obtained from alternative remote health service providers or physical health service providers.
  • Within the scope of this remote service, you can ask health professionals any questions you may have and ask for clarification on the procedures to be followed.
  • At any point in the remote service, you may request the termination of the relevant service (text messaging (chat), telephone/video conference call).
  • The online interview can be terminated unilaterally by the physician/dietician/clinical psychologist for medical, legal or moral reasons by informing the patient/client.
  • The person (institution) providing distance healthcare services is personally responsible for ensuring the security of the information systems, user names and passwords used in the provision of distance healthcare services.

Approval and Signature

I have read and understood the above information, I have had the opportunity to ask my questions and all my questions have been answered. I voluntarily accept the remote health services offered by One Dose Health Technologies within the framework of the information provided above.