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Informed consent form

onlinelogomaker-033118-2006-0829-2000-tr
Informed consent and consent to receive test results by email / fax
  1. I, the undersigned, approve  And I agree that the employees of the MEDICAL-SERVICE company will take a sample from me, so that they can perform tests in accordance with my request and in accordance with the details of the tests I submitted to the secretariat.

  2. It was clarified to me that the tests are performed in licensed and accredited laboratories on behalf of the Ministry of Health with which the MEDICAL-SERVICE company has an arrangement. I also know that there can be gaps between the results of the fund / hospital laboratories and private laboratories.

  3. It was clarified to me that MEDICAL-SERVICE is a private company of brothers and sisters that provide a nursing service and a private blood testing service. The company does not provide a decipherment of the test results that will be obtained. I know I have to  Go with the test results to a qualified medical professional or personal doctor, in order to get an explanation of the test results and further treatment.

  4. I received an explanation of how the procedure is performed such as: how the test is taken, where it is taken, date for coordination, necessary requirements for the test, duration of results and cost.

  5. I also agree and request to receive the results of the laboratory tests directly to the email I sent to the company. The lab answers will be sent from the email of the MEDICAL-SERVICE company and I will not have any claim that the email was sent on behalf of a third party.

  6. In the event of abnormal results, I agree that a qualified representative from the MEDICAL-SERVICE company will contact me and inform me of results that require the attention of a attending physician.

  7. In case of abnormal results I know that it is my responsibility to go to the personal doctor for treatment and I will not have any claim or lawsuit against the MEDICAL-SERVICE company.

  8. In addition, it should be noted that in the event of an illness requiring notification, the private laboratory must notify the local health bureau without delay, as required by the laws and regulations of the Ministry of Health.

  9. I {{First name - Name:}} {{Last name - Last Name:}} declare that my above consent was given of my own free will and that I understood all of the above, and I also received all the information I needed before signing a document It.
     

When submitting the form, I confirm the above.

Thank you for contacting MEDICAL-SERVICE. 

Thanks for submitting!

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